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   Table of Contents - Current issue
January-December 2019
Volume 29 | Issue 1
Page Nos. 1-19

Online since Friday, May 21, 2021

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Early postoperative wound infections in hemiarthroplasties in South-South, Nigeria: A multicenter-based study p. 1
Edwin Omon Edomwonyi, R E T Enemudo
Background: The most common treatment for displaced femoral neck fractures in the elderly patient is hemiarthroplasty. Postoperative wound infection is considered early when it occurs within 30 days of orthopedic operations. Infection rates vary in the literature. Availability of descriptive data is limited. Patients and Methods: Medical records of 40 out of 52 patients who had hemiarthroplasties in Irrua Specialist Teaching Hospital, Irrua, Edo State and Delta State University Teaching Hospital Oghara, 2007–2016 were reviewed retrospectively. All patients had prophylactic as well as presumptive antibiotic treatment. All had ceftriaxone and metronidazole at one point or the other. Results: Of the 40 patients, age range was 17–91 years; median age was 65 years with a slight female to male preponderance. Twenty-two (55%) patients were 60–90 years of age. Trivial/domestic falls accounted for the majority, 26 (65%) patients. Only 3 (7.5%) patients presented within 24 h. Hypertension (HT) was the most common comorbid medical condition, 67.5%. Wound infection was the most common complication noted 7 (17.5%). Polymicrobial (mixed) infection agents ranked the highest among the microbes' cultures. Five out of the seven patients with wound infection had superficial wound infection. Two had deep wound infections. Ceftriaxone and metronidazole were the most commonly used antibiotics and the most effective against infections. Genticin was uncommon. Conclusion: Sixty-seven percent of patients studied had wound infection. Superficial wound infections were the most predominant type of early postoperative wound infection, and polymicrobial mixed infection agents were the most implicated. HT was the most common comorbid medical condition identified.
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Catheter associated urinary tract infection offending pathogens, antimicrobial sensitivity, and complications p. 6
Charles Azuwike Odoemene, CO Adiri
Background: Catheter-associated urinary tract infection (CAUTI) is a source of morbidity in patients on indwelling urinary catheters. Patients in both outpatient and inpatient general wards can be on indwelling urinary catheters at one time or the other due to various underlying pathologies. These indwelling urinary catheters can attract microorganisms into the urinary tract causing CAUTI. The aim is to determine the offending pathogens, antimicrobial sensitivity, and complications in CAUTI. Patients and Methods: This was a prospective interventional study involving catheterized patients without prior urinary tract infection. The catheters were inserted due to various underlying pathologies either on an outpatient basis or on admission in the general ward. On suspicion of infection by the presence of any of these, cloudy urine, pericatheter pain, suprapubic pain, fever, chills or hematuria, and urine samples were aseptically collected by the laboratory scientist for culture and sensitivity. Any significant bacteriuria either asymptomatic or symptomatic was documented, and the offending pathogens also identified. Antimicrobial sensitivity patterns were recorded, and any complications noted in the patients were recorded. Results: A total of 460 patients, 376 (81.7%) males and 84 (18.3%) females were recruited into the study. The prostatic disease was the most common pathology necessitating urinary catheterization, accounting for 59.5% of all the cases. There were 100% recorded cases of CAUTI in the study. Escherichia coli was the most common organism isolated 45.2%. There was asymptomatic bacteriuria in 81% of the patients, while in 19%, it was symptomatic. There was multidrug resistance to the commonly used antimicrobials. Conclusions: CAUTI still poses enormous challenges to both the outpatients and general inpatients. To minimize CAUTI, indiscriminate use of urinary catheters should be discouraged and urinary catheters should be removed immediately; they serve the purpose for which they were inserted.
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Unoperated tetralogy of fallot: A natural survivor who refused for surgery at the age of 42 years – Was it ever too late to operate? p. 14
Ravisagar Patel, Abhinav Singh, Rajendra Mohan Mathur
Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. Survival after the age of 12 years without corrective surgery is rare. We present a case of 42-year-old Indian male with uncorrected tetralogy of Fallot. Possible reasons for the longevity in this patient are left ventricular hypertrophy and systemic to pulmonary shunting through mediastinal collaterals.
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Long loop vas – A rare entity: Case report and review of literature p. 17
Prashant Joshi, Nikhil Gawde, Siddhi Shetye
Long loop vas, encountered during orchidopexy for undescended testis, is a rare entity and deserves a note. We report the case of an 8-year-old child who presented with pain in the left groin and was clinically diagnosed to have undescended testis and palpable in the left groin. Ultrasonography confirmed the presence of testis in the left inguinal region. The incidental finding of long loop vas intraoperatively mandates careful dissection during surgery to preserve the viability of the testis. Examination for a looping vas by inspecting structures caudal to the testis should be done during orchidopexy to avoid inadvertent transection. In view of paucity of literature of long loop vas, our aim is to enhance the already existing scanty literature and suggest the effective single-stage management of this rare condition.
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