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Search Results: 1 - 10 of 15773 matches for " treatment outcome "
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Cut Throat Injuries—A Retrospective Study at a Tertiary Referral Hospital  [PDF]
Suman Arasikere Panchappa, Dhinakaran Natarajan, Thangaraj Karuppasamy, Alaguvadivel Jeyabalan, Radhakrishnan Kailasam Ramamoorthy, Sivasubramanian Thirani, Rajaganesh Kutuva Swamirao
International Journal of Otolaryngology and Head & Neck Surgery (IJOHNS) , 2014, DOI: 10.4236/ijohns.2014.36058
Abstract: Objective: To analyze the socio demographic pattern, sex and age ratio, common causes, the most common site and extent of the injury in the patients with cut throat injury at our hospital. To compare the same with previous similar studies conducted at other centers in different parts of the world. Setting: Department of ENT, Government Rajaji Hospital, Madurai, India from January 2013 to June 2014. Methods: A total of 51 cases of cut throat injury were included in the study. Separate proforma was prepared to collect the patients’ data. Structured questionnaire was offered. Results: 51 cases of cut throat injury patients were included in the study. Age varied from 4 years to 80 years. Out of 51 cases, there were 43 males, 7 females and one male child. Male to female ratio was 6.2:1. All the patients were belonging to lower socioeconomic status (Kuppusamy class 5). Amongst them 26 cases (50.98%) were due to homicidal attack; 13 cases (25.49%) due to suicidal attempt; 7 cases (13.72%) due to road traffic accident; 4 cases (7.84%) due to bull gore injury; 1 case (1.96%) due to accidental fall. Emergency tracheostomy was done in 16 cases (33.33%). An average hospital stay for most of the patients was less than 3 weeks. 2 victims (3.92%) died due to haemorhage, aspiration pnuemonia and septicemia. Conclusions: Our study found that the majority of the victims were males of age between 20 years to 40 years from poor socioeconomic status. Social commitment and political motivation, decrease in the poverty, individual awareness, increase in economic growth, and literacy rate will prevent the cut throat injuries. Early and improved management will reduce the mortality and morbidity.
Tuberculosis Arthritis of the Sternoclavicular Joint  [PDF]
Osman Walid, Triki Mohamed Amine, Kaziz Hamdi, Jemni Sonia, Naouar Nader, Ben Ayech Mohamed Laziz
Open Journal of Orthopedics (OJO) , 2015, DOI: 10.4236/ojo.2015.56018
Abstract: Tuberculosis remains a public health problem in developing country particularly in Tunisia. Bone location of tuberculosis infection is increasing and is often misdiagnosed due to the weakness of clinical presentation in early stages. Sternoclavicular joint tuberculosis is rare and unusual location of this disease. However, antibiotherapy and surgical debridement is still the basis of treatment. We report a case of sternoclavicular joint tuberculosis with a follow up of four years. The patient was treated surgically and put under antibiotherapy during twelve months. The site was sterilized. We report this case to show that debridement and antibiotherapy still efficient in tuberculous bone affection no matters the location.
Necrotizing Fasciitis of the Upper and Lower Limbs: Port Harcourt Experience  [PDF]
Rollings Jamabo, Solomon Elenwo
International Journal of Clinical Medicine (IJCM) , 2011, DOI: 10.4236/ijcm.2011.22017
Abstract: Background: Necrotizing fasciitis (NF) is a rare but life-threatening soft-tissue infection characterized by rapidly spreading inflammation and subsequent necrosis of the fascial planes and surrounding tissue. Aim: To determine the clinical characteristics at presentation, causative pathogens and clinical outcome of NF after aggressive management. Patients and methods: We retrospectively reviewed case notes of patients with NF referred to the Teaching Hospital in Port Harcourt from January 2004 to December 2009. Results: The case notes of over 2,280 patients with history of cellulitis and/or infections of the upper and lower limbs were reviewed. These cases were seen in a five-year period from 2004 to 2009. Seventy five (3.29%) patients had a diagnosis of necrotizing fasciitis and were evaluated. Only those with infections on the lower and upper limbs were further analyzed. Thirty five (46.67%) patients had their infections in the lower limb while 40 (53.33%) patients had their infections in the upper limb. Twenty (26.67%) patients were found to be diabetic on admission. Thirty (30%) patients sustained injuries on their limbs while 5 (6.67%) patients could not give account of their infections. Eleven (14.66%) patients had fixed flexion deformities as their wounds healed and had to have further plastic surgery to extend their limbs and 7 (9.33%) patients died while on admission. Conclusion: Although an early diagnosis of NF can be difficult, a high index of suspicion is required in all patients presenting with unexplained warmth and/or cellulitis of the limbs, so that prompt and aggressive debridement can be carried out with commencement of broad spectrum antibiotics.
Senning operation for correction of the transposition of the great arteries, results, long-term outcome and quality of life  [PDF]
Miguel Angel Maluf
World Journal of Cardiovascular Diseases (WJCD) , 2012, DOI: 10.4236/wjcd.2012.23036
Abstract: Objective: Long-term results after the Senning operation for transposition of the great arteries are little known. Sinus node dysfunction and systemic ventricular dysfunction are crucial in patient survival. We evaluated the results, long term outcome and quality of life in a group of 39 patients. Methods: The study was a retrospective analysis, of 39 (39/40 = 97.5%) surgical surviving patients, submitted to Senning operation, with a mean follow-up time of 14.7 +/– 3.1 years. Electrocardiogram, echocardiogram, and chest radiograph series were performed every 6 months. Thirty six patients of this series underwent Holter study and ergometric test, to evaluate the physical capacity. Three patients living overseas were excluded. Results: There was only one late death (1/39) (late mortality = 2.5%): a 16 year-old patient had a no cardiac death. The actuarial survival was 95.0% (38/40) (simple or with little VSD, TGA). The probability of staying in sinus rhythm, in 39 surviving patients was 77.1% (30) or normal right ventricular function was 76.5% (29), 10 to 20 years after operation. The incidence of sinus node and right ventricular dysfunction increased gradually over time. No re-operations and pacemaker implantation, was performed. Functional class: I = 30 (85.7%) cases and functional class II = 5 (14.3%) cases. Conclusions: Patients with simple TGA submitted to Senning procedure in our experience, presented during late follow-up: 1—Low incidence of right ventricular dysfunction and active arrhythmias; 2—Low mortality and no sudden death recorded; 3—Good quality of life and 4—Satisfactory surgical results (free of re-operation or definitive pacemaker implantation).
Combined Treatment Strategy and Outcome of High Risk Neuroblastoma: Experience of the Children’s Cancer Hospital-Egypt  [PDF]
Emad Moussa, Mohamed Fawzy, Alaa Younis, Maged El Shafei, Mohamed Saad Zaghloul, Naglaa El Kinaai, Amal Refaat, Noha Atta, Alaa El Haddad
Journal of Cancer Therapy (JCT) , 2013, DOI: 10.4236/jct.2013.49171

Background: Neuroblastoma (NB) is remarkable for its wide spectrum of clinical behavior and biological characteristics in relation to outcome. The use of aggressive therapy, including autologous hematopoietic stem cell transplantation (HSCT) and the addition of isoretionin (cis-Retinoic Acid/cis-RA), has increased survival rates of patients with advanced disease. Methods: Pediatric 271 newly diagnosed high risk NB patients were prospectively enrolled into the study. Patients received neoadjuvant chemotherapy of alternating cycles: [cyclophosphamide, doxorubicin, vincristine (CAdO)] and [etoposide, carboplatin]. Intensification courses of “ICE” (ifosfamide, carboplatin, and etoposide) regimen were administered to patients with bone marrow (BM) residual infiltration. Whenever safely feasible, complete surgical resection or debulking of the primary tumor was attempted for patients achieving partial response. Eligible patients underwent HSCT, while radiation therapy to the primary and metastatic sites, as well as maintenance with cis-RA was given for 6 months. Results: The median age of our patients was 2.8 years with male to female ratio of 1.65:1. At 4 years, the overall and event free survivals were 33.7% and 23.3% for the entire group under study, with significantly higher rates (42.7% and 35.6%, respectively) for HSCT patients (n = 94; p

Acute Kidney Injury: Treatment with Unani Medicine—Case Report  [PDF]
Muhammad Shakil Ahmad Siddiqui, Khan Usmanghani
Chinese Medicine (CM) , 2014, DOI: 10.4236/cm.2014.52014
A male named Anwer Jamal, age 45 years, married, visited Clinic Rafaheaam Dawakhana Ajmali on March 29, 2013, with history of glomerulonephritis, inherited renal diseases, hypertension and previously hooked on voltaren 50 (Diclofenic Sodium, 50 mg) and was not on dialysis. Different diagnostic parameters showed the patient was suffering from acute renal failure according to the RIFLE criteria. AKI is life threatening when kidneys suddenly is unable to filter waste products from blood. The patient was treated and managed with herbal medicines according to Unani system of medicine. Reversal of the parameter such as serum creatinine from 7.90 mg/dl (6.58 fold high) to 0.81mg/dl within two weeks clearly shows the remarkable recovery in a short period of time. During this period the other related parameters e.g. blood urea nitrogen (BUN), serum albumin, albuminuria, blood pressure were also normalized whereas clinical sign and symptom exhibited improvement.
Association between Weight Change during Treatment and Treatment Outcome in Patients with Smear Positive Pulmonary Tuberculosis  [PDF]
Mohammad Khajedaluee, Maliheh Dadgarmoghaddam, Davoud Attaran, Amirhossein Zabihi, Seyedhassan Ashrafi
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.46052

Tuberculosis (TB) is known as a disease of poverty and declared as a global public health emergency by World Health Organization (WHO). Pulmonary tuberculosis is the most common type of TB and is a wasting disease. It is expected that the patients who lost weight during the course of disease, will gain weight during successful treatment. So the aim of this study was to assess the body weight changes through the treatment and its possible association with treatment outcome in TB patients in Nishapur, an ancient city in Razavi Khorasan province in Iran. This is an observational analytical study. Patients were selected according to inclusion and exclusion criteria and available information. Treatment Protocol for all patients was Directly Observed Treatment, short Course Strategy (at least 6 months). All patients were weighed at the beginning of treatment, after two months and at the end of treatment. Outcome of treatment was classified into: cured, completed treatment, treatment failure and death. Then the impact of weight changes during treatment was compared in subgroups. From 874 patients, 819 patients (93.9%) were new cases, 48 (5.3%) relapse, 5 patients (0.6%) patients who did not complete their treatment and 2 (0.2%) had failed prior therapy. The most common symptoms in all patients were: cough, sputum, weight loss, fever, sweats, and hemoptysis. 8.1% of patients had radiologic signs and the most common signs were cavity (2.9%). The weight change during treatment was 2.91 ± 5.59 kg in cured group, 3.3 ± 3.29 kg in completed treatment group, 2.95 ± 5.59 kg in treatment failure group and 1.02 ± 3.27 in dead group respectively. These differences were statistically significant between the four groups (p < 0.03). We can conclude that body weight change can be used as a predictor for the treatment outcome.

Three-Year Outcome of Very Low Birth Weight Infants in Conservatively Managed Premature Rupture of Membranes  [PDF]
Jun Sasahara, Keisuke Ishii, Toshiko Kishimoto, Akiko Yamashita, Shusaku Hayashi, Nobuaki Mitsuda
Open Journal of Obstetrics and Gynecology (OJOG) , 2015, DOI: 10.4236/ojog.2015.51010

Aim: To elucidate the outcome for very low birth weight infants delivered after preterm premature rupture of membranes (PPROM) managed conservatively, and to determine the prognostic value of perinatal factors for long-term outcome. Methods: Perinatal data were collected from medical records for singleton live-birth infants delivered between 1991 and 2008 after conservatively managed PPROM. Cases of congenital anomalies and chromosomal aberrations were excluded. Poor outcome was defined as a composite measure of death, neurological morbidity including cerebral palsy, or neurodevelopmental delay. Associations between perinatal factors and poor outcome at the corrected age of 3 were estimated using logistic regression analysis. Results: After the exclusion, 356 infants meeting the study criteria were identified, 26 cases were lost to follow-up, and 330 were eligible at 3 years. The mortality rate was 10% and the incidence of neurological morbidities was 12%. Logistic regression analysis revealed gestational age at birth [adjusted odds ratio (aOR) 0.815], and five-minute Apgar scores (aOR 0.521) were independent predictors for poor outcome. Conclusion: When PPROM was managed conservatively, 22% of VLBW infants had a poor outcome at corrected age of 3 years. Early gestational age at birth and low Apgar scores were associated with poor outcome.

Arthroscopy Assisted Lesion Clearance and Bone Graft, Titanium Rod Support Treatment of Early Stage Osteonecrosis of the Femoral Head of the Postoperative Survival Rate Analysis  [PDF]
Xingming Yang, Wei Shi, Yakun Du, Lei Zhang
Surgical Science (SS) , 2017, DOI: 10.4236/ss.2017.81005
Abstract: Objective: To assess the curative effect of the stage II femoral head necrosis treated by arthroscopy assisted lesion clearance, bone graft and titanium rod support. Methods: All the patients (including 58 patients 74 hips) were diagnosed as stage II femoral head necrosis according to the ARCO staging system during 2003-2013. In these patients, 15 hips were stage IIA, 34 hips were stage IIB and 25 hips were stage IIC. Located by C-arm and assisted by arthroscopy, minimally-invasive percutaneous pulp core decompression and lesion clearance within the femoral head were accurately performed, and then, the OAM composite of autologous bone marrow was implanted and the femoral head was supported using the titanium rod. Follow-up including the pain score, the Harris hip score and X-ray observation for disease progression were achieved at 6, 12, 24 and 36 months postoperatively, Kaplan-Meier survival curve was used for the survival analysis. Result: The VAS score and the Harris score after operation were better THRAn THRAt of before the surgery, the difference had statistical significance (p < 0.05). As for the X-ray staging, 5 cases (5 hips) progressed from stage IIB to stage IIC, the femoral head of 6 cases (6 hips) staged IIC collapsed at 24 months after the operation and then underwent THRA after 30 months. In this study, the total improvement rate after the surgery was 79.72% (93.33% for IIA, 82.35% for IIB and 68% for IIC). The total survival rate of these patients was 64.2% (95% CI, 64.2% - 90.1%). Conclusion: Arthroscopy assisted lesion clearance, bone graft and titanium rod support to treat the stage II osteonecrosis of the femoral head are effective and can prevent the femoral head from collapsing. But for stage IIC patients who had a history of the use of hormone, this surgery should be chosen carefully because the outcome is always very poor.
Tuberculosis Case Notification and Treatment Outcomes in West Gojjam Zone, Northwest Ethiopia: A Five-Year Retrospective Study  [PDF]
Senedu B. Gebreegziabher, Solomon A. Yimer, Gunnar A. Bjune
Journal of Tuberculosis Research (JTR) , 2016, DOI: 10.4236/jtr.2016.41004
Abstract: Introduction: Tuberculosis (TB) is a major public health concern in Ethiopia. Analysis of TB case notification and treatment outcomes is crucial to understand the TB control program performance. The current study was carried out to assess trends of TB case notifications, treatment success rate and factors associated with unsuccessful treatment outcome among TB patients in West Gojjam Zone of Amhara Region, Ethiopia. Method: A retrospective cohort study was conducted in West Gojjam Zone. Demographic and clinical data were reviewed for all TB patients registered between July 2007 and June 2012 at 30 randomly selected public health facilities of the study zone. In addition, annual case notification reports of the study zone were used to analyze trends in TB case notifications. Logistic regression analysis was used to assess the association between potential predictor variables and unsuccessful treatment outcomes. Results: Tuberculosis case notification for all forms of TB decreased from 203/100,000 population in 2007 to 155/100,000 population in 2012. Among patients whose treatment outcomes were evaluated, 94.4% were successfully treated, 0.3% had treatment failure, 1.5% defaulted and 3.7% died. In multivariate analysis, the odds of unsuccessful treatment outcome was higher among retreatment cases than new cases (adjusted OR, 3.44; 95% CI: 1.92, 6.19). HIV co-infected cases were more likely to have unsuccessful treatment outcome compared to HIV negatives (adjusted OR, 2.68; 95% CI: 1.92, 3.72). Conclusion: Tuberculosis case notification rates showed a decreasing trend between 2007 and 2012. The treatment success rate exceeded the 90% treatment success rate target as set by the WHO. Special attention is required for patients with high risk of unsuccessful treatment outcome. Therefore, retreatment cases, and HIV positive cases need strict follow up throughout their treatment period.
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