Australasian Medical Journal
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Generalised Staphylococcal Pustulosis In A Neonate: A Case Report.
Get PDFPustular eruptions in a neonate are mostly benign, but several are serious and have infectious aetiology. A detailed history, complete physical examination and careful assessment of the lesions are essential for diagnosis. The need to investigate every neonate with pustules for an infectious aetiology is emphasized. This case of generalised pustulosis in a neonate is reported as it is an uncommon presentation of Staphylococcus aureus infection, diagnostic difficulty caused by atypical skin lesions and similarity of clinical features with other causes of neonatal pustular diseases
Orbital Myiasis by Green bottle fly
Get PDFAn 80-year-old farmer, presented with large, maggot infested ulceration involving the medial part of the right upper lid. The left eye was phthisical. There was history of untreated traumatic laceration of the right upper lid. Mechanical removal of maggots was done under turpentine coverage with regular antibiotic dressing. Microbiological examination of maggots revealed the larvae to be of Lucilia sericata (green bottle fly). The ulceration completely healed in two weeks following manual removal of maggots and regular dressing. Orbital myiasis is an uncommon clinical condition, with isolated case reports in the literature
Variation in the Lobar Pattern of the Right and Left Lungs: A Case Report
Get PDFThe right lung has three lobes and two fissures while the left lung has two lobes and one fissure. During a routine dissection we observed a variant complete fissure and three incomplete fissures in the right lung while the left lung presented with a variant transverse fissure separating the superior lingual and anterior bronchopulmonary segments. In the right lung, the incomplete fissures lie between the apical and posterior bronchopulmonary segments; medial and lateral bronchopulmonary segments; apical and basal bronchopulmonary segments. The complete variant fissure separates the medial basal bronchopulmonary segment from the remaining basal segments. Such variant fissures and lobes are clinically important in cases of lobotomy
Quinine induced Torsade de pointes ventricular tachycardia in a 4 year old girl: possibilities and management
No full textTorsades de pointes ventricular tachycardia (TdPVT) is a rare life-threatening arrhythmia and may be underlying cause for sudden cardiac death in patients with structurally normal hearts. It is a distinctive form of polymorphic ventricular tachycardia (PVT) characterized by a gradual change in the amplitude and twisting of the QRS complexes around the isoelectric line. A wide variety of drugs including antimalarials are known to cause Torsades de pointes. Antimalarial drugs deserve utmost attention as they are commonly prescribed even at the primary care center and community level. We report a case of Torsades de pointes ventricular tachycardia in a 4 year old girl following oral quinine ingestion and that was successfully managed with magnesium sulphate and supportive treatment
Diabetes Management in Aged Care Facilities
No full textBackground There is gap in the literature regarding the current practice of diabetes management of the elderly in Australia and its compliance with available Australian diabetes practice guidelines. Aims The aims of this study were to describe the pharmacological management of elderly residents with diabetes living in aged care facilities and to identify areas for improvement in the current management as recommended by the current diabetes management guidelines in Australia. Method Residents with diabetes from three rural aged care facilities were identified by nursing staff. A cross-sectional medical record audit was carried out to obtain data of residents diagnosed with diabetes. Thirty-four medical records were audited from three aged care facilities. Data including demographics, medical histories and medications were collected and analysed Results This study had two key findings; Firstly, it showed that about a third of residents with type 2 diabetes are managed with diet only. Secondly, of the residents who are managed with medications, less than half of those audited (41%) were managed according to the current diabetes guidelines in terms of pharmacological treatment which included anti- hypertensive, lipid lowering and anti- platelet therapies. Of those patients with a history of CVD, all were receiving an antihypertensive medication, 71% were not managed for their lipids and 20% were not on any prophylactic anti-platelet therapy. Conclusion Management of patients with diabetes living in rural aged care facilities is inconsistent with the current management guidelines. Educational interventions targeting health professionals and patients might be beneficial to increase compliance with the current diabetes guidelines
Representation of Assertions in Clinical Free Text using SNOMED CT
No full textBackground Free-text clinical reports are often unstructured and make it difficult to aggregate information. A standardised representation of useful information in clinical text data is therefore important for facilitating retrieval and analysis. Aims To investigate the feasibility of using Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT) as a standard reference terminology for representing medical concepts and their assertions in clinical free text. Method The semantics encoded in SNOMED CT was proposed to automatically represent concepts and assertions in free text. Representations for the encoding of these entities were achieved using SNOMED CT expression templates. Results SNOMED CT expression templates were able to be developed to populate medical concepts and assertion data from the free text. A corpus of 726 clinical free text reports containing 30,518 assertions was used to evaluate the proposed methodology and among these 93.8% of the assertions could be represented using SNOMED CT. Conclusion The SNOMED CT representation of medical concepts and assertions in clinical free text show promise. Frequently occurring assertions such as “present,” “absent” and “possible” can be readily represented, while future work will still need to improve the coverage of other assertions typically found in the free text such as “Conditional” and “Hypothetical”
