{"title":"Aggressive Surgical Management of Spontaneous Intramuscular Haematomas in Patients with Cirrhosis is an Important Therapeutic Option","authors":"D. Verran, Mbchb, Mhsm, Fracs","doi":"10.36811/osjs.2019.110008","DOIUrl":"https://doi.org/10.36811/osjs.2019.110008","url":null,"abstract":"One known medical complication in patients with cirrhosis of the liver is sudden onset gastrointestinal haemorrhage which is usually variceal in nature and can be life threatening [1]. On occasion spontaneous haemorrhage from varices in other locations may also occur [2]. In addition, episodes of either intraabdominal or intrapulmonary haemorrhage are also associated with poor clinical outcomes in cirrhotic patients [3,4].\u0000\u0000In comparison relatively, few cases of spontaneous intramuscular haemorrhage in patients with cirrhosis have been reported up to now. This particular clinical entity has been predominantly the subject of sporadic case reports or case series. Apart from one small case series [5], the majority of the cases were summarised in a published review in 2015 [6]. Hence the most recent case report from Mongelli et al published recently in this journal [7], now becomes the 25th case.\u0000\u0000Keywords: Cirrhosis; Spontaneous; Haemorrhage; Intramuscular; Management; Surgery","PeriodicalId":301029,"journal":{"name":"Open Scientific Journal of Surgery","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130373576","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}
A. Elbaih, Z. Elsayed, Magda Ramadan El bahrawey, Maram Mahran Khalaf
{"title":"Adherence of Emergency Physicians to Pediatric Emergency Care Applied Research Network-Clinical Decision Rule (PECARN-CDR) in Minor Head Injuries Emergency Patients","authors":"A. Elbaih, Z. Elsayed, Magda Ramadan El bahrawey, Maram Mahran Khalaf","doi":"10.36811/osjs.2019.110007","DOIUrl":"https://doi.org/10.36811/osjs.2019.110007","url":null,"abstract":"Introduction: Pediatric Emergency Care Applied Research Network (PECARN) is the best accurately identify children at very low risk of clinically important traumatic brain injuries (ciTBIs) in the Emergency Department (ED). Therefore, the implementation of evidence-based tools for clinical decision-making in the acute care setting has shown to improve quality of care as well as patients’ outcomes. This study aimed to assess the PECARN on quality of care in mild head injury children after improving competency of emergency physician.\u0000\u0000Methods: The study is a cross-sectional, prospective study included 50 Children with mild head trauma attending to the Emergency Department (ED) of the Suez Canal university Hospitals. Patients divided into two groups according to their age (less or more than 2 years). We used the Statistical Package of Social Science (SPSS) program version 20 for data analysis.\u0000\u0000Results: The most common cause of injury was direct head trauma, followed by motor car accidents and the least frequent injuries were due to fall from height. Our results regarding the adherence of residents to the PECARN CDR demonstrated that the residents were adherent largely to the rule with a level of adherence of about 92%.\u0000\u0000Conclusion: the adherence of the emergency department physicians in SCUH to the PECARN CDR while managing pediatric mild TBI. PECARN proved its effectiveness as a clinically predictive tool to understand who can safely avoid a cranial CT scan after TBI and the risk stratification provided by it was significantly associated with positive CT scan findings.\u0000\u0000Keywords: Pediatric care; Mild head injuries; Traumatic brain injuries","PeriodicalId":301029,"journal":{"name":"Open Scientific Journal of Surgery","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132271979","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":"Quality of life patients with anorectal disorders","authors":"Ahmadova Esmira Vaqif","doi":"10.36811/OSJS.2019.110006","DOIUrl":"https://doi.org/10.36811/OSJS.2019.110006","url":null,"abstract":"Nowadays, assessment of treatments effectiveness carried out by different methods. About 20 years before due to clinical signs we can make a decision about the severity degree of disease, patients health status. However, now it is not enough. The most important lack of this approach is that in this situation patient’s opinion is neglected. Development of medicine, changing of relationship between patients and doctors give birth to a new direction: unilateral approach replaced by mutual cooperation both of sides. Until the last decades of XX century all treatment results, both conservative and surgical, were evaluated due to the clinical, laboratory and instrumental investigations. As officials defined by the World Health Organization, health is a state of complete physical, mental and social wellbeing [6]. So, during the patient’s conditions assessment all these parameters should investigate. Firstly, Errington in 1966 gave an idea about using quality of life for the describing disease effects. Officials this terming in medicine was established in 1977 [3]. Since that time “Quality of life” used widely in the medicine. Today this is one of the common, convenient and informative methods, which allow physicians assess the patient’s status by following the main rule of medicine- to treat the patient, not the disease [2,4,5]. Its advantages are:\u0000\u0000Comprehensiveness - it covers all aspects of health Dynamism- allow to monitoring patients status Patients participation- this is the main benefit.","PeriodicalId":301029,"journal":{"name":"Open Scientific Journal of Surgery","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126953292","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":"Slipped cervical disc: Treatment by means of, all in one","authors":"I. Arrotegui","doi":"10.36811/osjs.2019.110005","DOIUrl":"https://doi.org/10.36811/osjs.2019.110005","url":null,"abstract":"Concept\u0000\u0000Slipped disc is the exit of the nucleus pulposus material through the broken fibrous annulus.\u0000\u0000Epidemiology\u0000\u0000Along with lumbar disc, cervical disc is one of the most frequent neurosurgical diseases today, probably due to the new habits of modern, more sedentary civilization. The loss of muscle component weakens the complex structure of the spine. Added to this is the attitude maintained, in our usual work position, of the sitting position, inclined slightly forward and with the head bent, which causes an even greater load to be placed on the intervertebral discs than if we are in an upright position. And, to top it off, in an extemporaneous and irregular way, we submit an unusual effort to the column (exercises or sports not well controlled, efforts at work or at home, etc.).","PeriodicalId":301029,"journal":{"name":"Open Scientific Journal of Surgery","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122262252","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":"Medical-legal aspects and risk management","authors":"I. Arrotegui","doi":"10.36811/OSJS.2019.110004","DOIUrl":"https://doi.org/10.36811/OSJS.2019.110004","url":null,"abstract":"Complications of spinal surgery are an important source of professional liability judgments for trauma surgeons and neurosurgeons who develop this subspecialty. The disc pathology leads all the rankings of claims against these professionals. [1,2,3] This situation does not attract attention, given that lumbar and cervical disc hernias are frequent affections and more and more surgeons are turning to this activity. For the current neurosurgeon, the pathology of the spine tends to represent 50% of its benefits [4]. The high cost of agreements and sentences in cases of spinal surgeries is a reflection of the infrequent but severe damage that can occur when working millimeters from the spinal cord and nerve roots.\u0000\u0000Spine surgery has all the ingredients that can make a trial a nightmare. In general, patients with pathologies that do not threaten life, where the main symptom (pain) has a strong subjective component and where often the opinions of experts differ between conservative and radical approaches. There are several alternatives that are not always adequately reported to the patient, who may be surprised at evolutions that were not anticipated. On the other hand, in the case of quadriplegic or paraplegic patients, the costs of lost profits and future expenses are usually millionaires [5,6,7,8]. It is an extensive, varied and complex discipline and there are many authors who suggest the need to convert it into a new specialty [4] [9,10]. Spinal surgery is technically difficult and acquiring the necessary skills demands years of learning. The margin of error is minimal and only careful attention to detail in the pre, intra and postoperative ensures consistent good results. When complications arise and judgments for professional responsibility, the rush in the surgical decision (except in cases of clear urgency) and the lack of adequate information to the patient are usually aspects widely debated by all parties.","PeriodicalId":301029,"journal":{"name":"Open Scientific Journal of Surgery","volume":"177 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123424587","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":"Typhoid ileal perforation in Shisong, Northwestern Cameroon","authors":"B. Alegbeleye","doi":"10.36811/OSJS.2019.110003","DOIUrl":"https://doi.org/10.36811/OSJS.2019.110003","url":null,"abstract":"Background: The study aims to provide an overview of the spectrum of perforated typhoid fever cases and their outcome that were managed in resource constrained rural mission hospital, Northwestern of Cameroon.\u0000\u0000Methods: This was a retrospective observational study which was conducted in St Elizabeth Catholic General Hospital, Shisong, Northwestern region of Cameroon over a two year period covering January 2016 and December 2018. The patients included were those admitted and diagnosed of typhoid ileal perforation. Data collected were analyzed using SPSS computer software version 22.\u0000\u0000Results: During the study period, thirty-eight patients underwent surgery for typhoid ileal perforation. They included 26 (68.43%) males and 12 (31.57%) females with Male to Female ratio of 2.2: 1. Sixty -five percent of cases occurred between the months of July and September. The most common presentations were with abdominal pains (92.11%), and abdominal distention (92.11%). X-ray abdomen revealed pneumo -peritoneum in 26 (68.4%) cases, while ultrasound detected free peritoneal collection in 34 (90%) cases. Perforations were surgically treated depending upon the number of perforations, general health status of patient and degree of fecal contamination. Perforated typhoid still carries dismal prognosis. The mortality was associated with duration of delay in obtaining blood pre - operatively for patients requiring transfusion (p=0.018) and duration of presentation to operation time interval (p=0.026).\u0000\u0000Conclusion: Typhoid intestinal perforation is still endemic in our setting with dismal prognosis. Urgent public health concerted effort is required with emphasis on preventive measures such as safe drinking water, appropriate sewage disposal, and typhoid vaccination. Educating the populace on early and prompt diagnosis, adequate resuscitation as well as early surgery in patients with typhoid ileal perforation to keep the mortality low.","PeriodicalId":301029,"journal":{"name":"Open Scientific Journal of Surgery","volume":"179 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132025341","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":"Mucosal stripping and muscular layer quilting in the treatment of anal canal duplication: Operative technique","authors":"D. Güney, E. Şenel","doi":"10.36811/OSJS.2019.110002","DOIUrl":"https://doi.org/10.36811/OSJS.2019.110002","url":null,"abstract":"Anal canal duplication (ACD) is the least frequent digestive duplication [1]. It presents as a perineal orifice that ends with a tract along the anal canal [2]. Symptoms are often absent but can occur or worsen with age. Surgical excision of the duplicated anus is required because of the risk of infection and malignancy [3]. Here we present a patient with ACD that was treated with a technique that we pioneered called mucosal stripping and muscular layer quilting (MSMQ). This technique was performed for the first time in our clinic 11 years ago on 2 patients and has been described in a case report [4]. We describe the surgical technique here using a case presentation with photographs that illustrate the technique.","PeriodicalId":301029,"journal":{"name":"Open Scientific Journal of Surgery","volume":"135 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122245889","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}
F. Mongelli, Francesco Proietti, M. Patella, S. Cafarotti
{"title":"Life-threatening spontaneous hematoma of the chest wall treated with packing and delayed chest closure","authors":"F. Mongelli, Francesco Proietti, M. Patella, S. Cafarotti","doi":"10.36811/osjs.2019.110001","DOIUrl":"https://doi.org/10.36811/osjs.2019.110001","url":null,"abstract":"Bleeding of the thoracic and abdominal wall most commonly occur in anticoagulated patients [1]. The management is based on anticoagulant therapy reversal which is mostly effective [2]. If conservative treatment is insufficient, good results are provided by endovascular embolization techniques [2,3]. The need of surgical intervention is extremely rare and limited to cases in which minimally invasive techniques are unsuccessful or somehow contraindicated [4].","PeriodicalId":301029,"journal":{"name":"Open Scientific Journal of Surgery","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133657290","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}