Australasian Medical Journal
Not a member yet
1482 research outputs found
Sort by
Painful shoulder? Remote clinical management of a Field Guide with shoulder pain and loss of shoulder function in Antarctica
No full textWe report the case of a female Field Guide based at the British Antarctic Survey’s Rothera Science Research Station on Adelaide Island, Antarctica who independently contacted a physiotherapist specialising in climbing related injuries (GJ) located in the UK. for a second opinion. The Field Guide was experiencing significant work difficulties due to shoulder pain and subsequent loss of function particularly in overhead activities. The case raises important issues about the medical management of Field Guides operating in extreme environments and remote locations
Angle closure glaucoma secondary to psychotropic medications
Get PDFBackgroundPsychotropic medications are commonly associated anticholinergic side-effects. In susceptible patients, this can result in angle closure induced permanent loss of visionAimsTo review the mechanism of angle closure and which psychotropics are most likely to precipitate this complication.MethodsLiterature review surrounding the mechanism of angle closure and pharmacology of various psychotropicsResultsMydriasis, forward-displacement of the lens-iris diaphragm and ciliary body swelling are the mechanisms by which angle closure occurs. Anticholinergic side effects of psychotropic medications are most implicated in causing this.ConclusionScreening patients for risk factors of angle closure and either having them formally assessed or choosing psychotropics with minimal anticholinergic effects may avoid inducing angle closure
Pharmacokinetic study of intravenous posaconaozle in a critically ill patient with multiple organ failure
Get PDFPrescribing antimicrobial therapy in critically ill patients is challenging given lack of standard recommendation. Herein, a pharmacokinetic study of intravenous posaconazole was conducted to confirm plasma and tissue concentrations in a 37-year-old patient with invasive Aspergillus terreus infection coincided with renal and hepatic impairment. After dosing adjustment to 300mg every 48 hours, posaconazole exposure using area under the concentration-time curve (AUC) and average concentration (Cavg) reached the target recommendation. However, no significant accumulation of tissue posaconazole was found. Moreover, hyperbilirubinemia may have an influence on posaconazole pharmacokinetics that further studies are needed to explain this phenomenon
Toe salvage procedure for the recurrent chondromyxoid fibroma
No full textThe treatment options for recurrent chondromyxoid fibroma of the toe range from total amputation to salvaging a functional toe. There is no globally accepted treatment protocol available for this tumour because of its rarer incidence and lack of population based data. Here we suggest performing a staged approach, which involves en block resection initially and maintenance of metatarsophalangeal space by using a kirshner wire with the bone cement. If there is no sign of malignancy in the histopathology, we recommend performing interposition arthroplasty at the metatarsophalangeal joint with the tricortical iliac crest graft. The kirshner wire should be kept which incorporates the iliac graft and the soft tissue, which is being interposed at the metatarsal head. This will cause pseudoarthrosis and also decreases the chances of having chronic pain. We believe that this staged approach which leads to toe salvage is the best suitable treatment option for the recurrent chondromyxoid fibroma. This will prevent amputation of the toe and will give cosmetic success to the patient
Non-sexually related acute genital ulcers in a pubertal girl
Get PDFAcute genital ulcers (AGU), also known as acute vulvar ulcers or Lipschütz ulcers, is an uncommon, non-sexually transmitted condition characterized by the sudden onset of painful necrotic ulcerations of the vulva or lower vagina. Their aetiology and pathogenesis are still unknown. They may be preceded by influenza-like symptoms, such as fever, headache or respiratory symptoms. We presented a case of pubertal girl with multiple painful ulcers on the vulva who visited our hospital. Other causes of vulvar ulcers were excluded by history taking, laboratory tests, and skin biopsy. We presented a case report of pubertal girl with non-sexually related AGU
Myoclonus from antibiotic therapy (Ceftazidime-induced Neurotoxicity): A case study and review
Get PDFA 78-year-old Chinese man with a history of end stage renal disease (ESRD) presented with fever of one day duration. He was treated for catheter related sepsis with intravenous piperacillin and tazobactam, which was later switched to vancomycin and ceftazidime secondary to persistent fever with negative cultures. One the fifth day of treatment with vancomycin and ceftazidime, he developed new onset upper limb myoclonus which progressed to bilateral upper limb ataxia. A provisional diagnosis of myoclonus and ataxia secondary to neurotoxicity related to ceftazidime was made and the ceftazidime was ceased. His symptoms resolved over three days and he returned to his baseline neurological status by Day 5 following cessation
The present-day scope of practice and services of the traditional healer in South Africa
No full textBackgroundThe scope of practice of the traditional healer in South Africa is not guided or circumscribed by any statutory mandate at present. The traditional healer’s practice and services are currently based on and driven by the supernatural and the afterlife, lacking not only a scientific foundation, but also legal constraint.AimsThis study aimed to determine and describe the present-day scope of practice and services of the South African traditional healer.Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the scope of practice and services of the South African traditional healer. The findings are offered in narrative form.Results There is no established curriculum and practice culture to serve as an evaluation and descriptive criteria for the present-day traditional healer’s scope of practice.ConclusionThe South African traditional healer’s practice and rights are unwritten and legally unregulated, especially when viewed against in comparison with the current practice customs, traditions and rights of the South African statutorily regulated healthcare practitioners
To rub shoulders with the traditional health practitioner or not, that is the question for the medical doctor in the New South Africa
No full textBackgroundThe South African medical doctor has been well established over the years as the keeper of the holy medical grails. Entrance for newcomers to the medical domain has not been and is still not easy. The hostility towards the allied professions in the 1950s and later in the 1980s provides evidence of this. Certain prerequisites for entrance were set and jealously guarded by the medical fraternity. The Traditional Health Practitioners Act, (Act No 22, 2007) is another such a challenge. This time it is not an outsider fraternity that is fighting alone for its own recognition. They are backed by a government and political force to get the traditional health practitioner (previously known as the traditional healer) statutorily recognized.AimsThe study aimed to reflect on the future professional relationship between the medical doctor and the traditional health practitioner in South Africa.Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the future professional relationship between the medical doctor and the traditional health practitioner in South Africa. The findings are offered in narrative form.Results It is clear that the Traditional Health Practitioners Act No 22 (2007) will put enormous pressure on the medical doctor, not only to relinquish some of his healthcare empowerment, but also to see and to accept the traditional health practitioner as a new, respectable health co-practitioner and colleague. Facts hereto reveal that there are in terms of training, health ethics, practice approaches, attitudes and views, basically not a single point of similarity or agreement between the medical doctor and the traditional health practitioner whatsoever. Notwithstanding these enormous differences, the existence of the Traditional Health Practitioners Act No 22 (2007) is a fact that the medical doctor can not erase easily from the South African law books.ConclusionThe traditional health practitioner and the traditional health fraternity will not easily be absorbed into the formal healthcare establishment, notwithstanding the intentions of Section 49 of the Traditional Health Practitioners Act No 22 (2007) to reach this goal over time. Whether the traditional health practitioner will become a true and beloved colleague of the medical doctor, who rubs shoulders with him in his practice, remains to be seen
Prevalence and risk factors of diabetic retinopathy in Saudi Diabetics in Majmaah City
No full textBackgroundDiabetes mellitus (DM) is one of the most common chronic diseases worldwide. Diabetic retinopathy (DR) is the most common complication of DM and it is the leading cause of blindness in the Kingdom of Saudi Arabia.AimsThe study was conducted to determine the prevalence and risk factors of DR in patients with type II DM in Al Majmaah City, Saudi Arabia.Methods We conducted this cross-sectional study from February 2014 until May 2015. Out of the 1546 diabetic patients registered in the primary care centres of Majmaah city, a random sample of 327 patients were selected. An expert ophthalmologist took a detailed history and performed ophthalmic examination on all patients. Mean ± S.D was measured for quantitative variables. Frequencies and percentages were given for qualitative variables. Logistic regression was applied to associate DR with alleged risk factors.Results The prevalence of DR among the study group was 35.8 per cent. Non-proliferative diabetic retinopathy was prevalent in 31.8 per cent cases. We tested the association between DR and various risk factors. We found that patients, who develop DM when they were between 40 and 60 years, have more chance to develop DR.ConclusionDR is affecting more than one third of diabetic patients in Saudi Arabia. There is an urgent need to establish and promote national screening and management programs for DR. Delaying the onset of DM after the age of 60 may help to lessen that problem