Australasian Medical Journal
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A rare presentation of Escherichia coli urosepsis complicated by myositis
Get PDFPyomyositis is a purulent infection involving the skeletal musclesas a result of haematogenous spread. Escherichia coli (E. coli) is a rare cause for pyomyositis and previous published case reports mainly involved immunocompromised patients with haematological malignancies. We present a case of a 42-year-old immunocompetent female with confirmed E. coli urosepsiscomplicated by development of stage 1 pyomyositis. Early detection is essential where pyomyositis should still be suspected as a differential diagnosis in immunocompetent patients with confirmed E. coli bacteraemia with signs of suspected localised muscle infection
Are we facing NOVICHOK nerve agent threat?
Get PDFIn the short history, at least four similar attacks by nerve agents were committed. In this short communication, we wanted to interlink some important insights into nerve agents and novichoks and point out that the latest assault by novichoks is not the only attack with prohibited chemical warfare agents and, unfortunately, probably not the last, as these substances can easily be synthesized in a well-equipped chemical laboratory
Barriers to support nurses as second victim of medical errors: A qualitative study
Get PDFBackgroundGiven the inevitability of medical errors and their impact on health workers, providing support to those who suffer is vital for their physical and mental recovery. Identifying the barriers to obtaining support is imperative in this regard.AimsThe current study was conducted to identify the barriers regarding supporting nurses as second victims of nursing errors in clinical settings in Iran.MethodsThis qualitative study was conducted with a sample, which was included 18 nurses. The subjects were selected through the purposive sampling method, and data were collected using in-depth and semi-structured interviews. The data were analysed using methods as described by Graneheim and Lundman (citation needed). The research context included the general and specialized departments of hospitals in Tehran, Iran, during 2017.ResultsAccording to the results, mismanagement, Cultural barriers, inadequate information, and Legal barriers were the main barriers to supporting nurses.ConclusionTraining nurses about the second victim phenomenon is recommended as well as the methods to manage the effects of this phenomenon, the supportive resources, and legal issues
Serum vitamin D and asthma control still a controversial link: A cross-sectional study and literature review
Get PDFBackgroundVitamin D is an important modulator of the innate and adaptive immune system, plays an important role in the airway hyperresponsiveness and the improved asthma control. Several studies suggest that low serum vitamin D may adversely influence asthma outcomes. However, other studies showed inconsistent relationship which increased the controversy of the link between low vitamin D and asthma control.AimsThe aim of this study was to investigate the potential relationship between low serum vitamin D with asthma control.MethodsA cross-sectional study of consecutive patients with the diagnosis of asthma from the outpatient clinic at King Abdulaziz University hospital was analysed between January and December 2011. They were classified according to their asthma control level. Measurement of serum vitamin D was performed. SPSS was used to examine any statistical correlation.ResultsSixty-four asthmatic patients were included in this study; 31.25 per cent (n=20) males and 68.75 per cent (n=44) were females. Serum vitamin D (25-hydroxyvitamin D) deficiency (Less than 50nmol per litre) was found in 84.3 per cent (n=54), insufficiency (50 to 74.9 nmol per litre) in 14.1 per cent (n=9), and sufficient serum level (75 nmol per litre or greater) in 1.6 per cent (n=1) patients. Level of asthma control assessment based on GINA guideline revealed 25 (39 per cent) uncontrolled, 27 (42.2 per cent) partially controlled and 12 (18.8 per cent) controlled patients. Low vitamin D was found in 12 (19 per cent) controlled versus 51 (81 per cent) non-controlled asthmatics. There was no significant statistical correlation found between low serum vitamin D level and asthma control (p value 0.85).ConclusionLow vitamin D was prevalent in more than three-quarters of patients with asthma. The relationship between low serum vitamin D level and poor asthma control was not statistically significant. Further studies are needed to explore the association of low vitamin D with asthma control
Lobectomy versus total thyroidectomy in differentiated thyroid carcinoma: A review
Get PDFBackgroundThyroid cancer is on the rise globally, there is increasing adoption of lobectomy for low-risk differentiated thyroid cancer.AimsThe current review aimed to assess lobectomy versus total thyroidectomy in low-risk differentiated thyroid carcinoma.Methods A systematic electronic search was conducted in the Pub Med and Google Scholar with no limitation of the period, 85 articles published in English were retrieved, two researchers screened the abstract for removal of duplications. Twenty-one articles fulfilled the inclusion and exclusion criteria.Results Among the twenty-one articles included (more than two-thirds were retrospective), eleven were from the USA, two from Europe, six from Asia, one from Canada and one from Australia. The results were mixed, some preferred lobectomy, others were on the side of total thyroidectomy, while some advised to weigh the risks and benefits.ConclusionThe results were mixed regarding the mode of surgery in low-risk differentiated thyroid cancer. Further, well-designed studies are needed to solve the current controversy
Personalised three-dimensional printed coronary artery models for accurate assessment of coronary stenosis using high resolution imaging modality
Get PDFOptimal protocols for quantitative assessment of breast density using magnetic resonance imaging
Get PDFFear levels of the childbirth of primiparaous women applying to emergency obstetric unit
Get PDFBackgroundEmergency service is a complex and dynamic environment mostly simultaneously managing the conditions of different patients and which is delicate in terms of time. Health care providers should be aware of influence the environment during labour.AimsThe aim of this research was to determine the level of fear of childbirth of primiparaous women, who has applied to emergency obstetric units. We also examined some variable which could effect on the level of fear of childbirth such as reasons for applying the emergency obstetric units, knowledge about birth process and readiness to birth.MethodsThis study is a cross-sectional study. The sample of the study is 473 primiparaous women who have applied to emergency obstetric units. A personal information form and ";;;Wijma Birth Expectancy / Experience Scale Version";;; have been used to determine the fear level of childbirth by conducting face-to-face interviews.ResultsIt has been determined that 67.7 per cent of the pregnant women have applied to the emergency unit due to pain. It has also determined that the mean score of fear of childbirth is 66.33±25.25 among women who have applied to emergency services. Also, 21.8 per cent of the women have been found to have a fear of childbirth at a severe-clinical level. Women who have early membrane ruptures have the highest level of fear of childbirth. There is also significant difference between women’s fear of childbirth level depending on knowledge about birth process, readiness to give birth and desired/planned birth (p=0.000).ConclusionThis study showed that on third of the primiparaous who apply to emergency obstetric care has a severe grade of fear of childbirth. It has been determined that fear of childbirth has been found to be lower in the women who has received childbirth education, who has known what they would live during birth, and who has felt ready for delivery. This finding suggests that childbirth education is important to provide low level fear of childbirth for women who apply to emergency obstetric unit
Retroperitoneal pelvic invasion in ovarian cancer: Possible modes of spread and survival impact
Get PDFBackgroundOvarian cancer is the second-most common malignancy and the leading cause of death in women who develop cancers of gynaecologic origin and it spread primarily by direct exfoliation of cells along the peritoneal surface. Interesting fact, although not well studied, is that these tumours invade the mesothelium but very rarely they invade the peritoneum deeper through direct extension.AimsTo study the retroperitoneal pelvic invasion in parametrial ligaments and vagina in patients undergoing surgery for advanced epithelial ovarian carcinoma and the survival impact of it.MethodsThe study included 59 patients with advanced epithelial ovarian cancer that underwent radical hysterectomy during the 2004–2009 period. For the purpose of this study histopathologic examination was performed for the parametrial ligaments and vagina with inspection of the surgical resection lines.Results Retroperitoneal pelvic invasion was found in 42.4 per cent of the cases, involving different depths of parametrial ligaments and/or vaginal spread, and is associated to worse survival outcomes.ConclusionRetroperitoneal pelvic invasion is not a rare phenomenon and seems to be a feature of the more aggressive tumours. In the cases of distal retroperitoneal pelvic invasion (vaginal) the patients’ 5-year survival rate is similar to that of the stage IV ovarian cancer patients
Knowledge and utilization of colorectal cancer screening in Saudi society
Get PDFBackgroundIn Saudi Arabia (SA), cancer is a major burden on the healthcare system. It has a great impact on both the social and economic aspects of the patient. The Saudi cancer registry reports an increase in the incidence of all cancers since the first report in 1994. Colorectal Cancer (CRC) is the most common type of cancer in SA.AimsTo measure the utilization and the knowledge of Saudi population about screening for CRC and the awareness of the society towards CRC incidence and risk factors.Methods A questionnaire-based cross-sectional survey was conducted with simple random sampling of 636 individuals between February 2018 to May 2018. The questionnaire comprised of 19 questions covering personal data of the participant, degree of awareness about colorectal cancer in Saudi Arabia, and information about colonoscopy and how it’s done.Results The known risk factors for CRC, that are inflammatory bowel disease (IBD), smoking and polyps, were recognized by less than 50 per cent of the respondents. Almost two thirds of the respondents were willing to do screening. Willingness to do screening was significantly associated with a history of colonoscopy for the respondent or a relative.ConclusionThe knowledge and awareness of our sample about CRC was low. Raising the level of knowledge is anticipated to increase the readiness to do screening