Australasian Medical Journal
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Isolated Hepatic Tuberculosis: an uncommon presentation of a common entity.
Get PDFHepatic tuberculosis is commonly encountered in patients with widespread miliary disease. Isolated affection of the liver is extremely rare. We present a case of a young woman who presented with a subacute afebrile hepatic failure. Investigations including a liver biopsy proved that the presentation was due to granulomatous hepatitis secondary to mycobacterial infection of the liver. It is important that tuberculosis be kept in mind especially in endemic areas even in atypical clinical scenarios by clinicians, radiologists, and pathologists. Use of anti-tuberculous drugs in such cases is usually successful and must be instituted early
Medical Errors and Barriers to Reporting in Ten Hospitals in southern Iran
No full textBackground [International research has shown that medical errors are a major threat to patient safety.] Aims [The present study aimed to determine the frequency and barriers to reporting medical errors in Shiraz public hospitals, Iran. ] Method [This retrospective analytical study was conducted in Shiraz public hospitals in 2013. Using the standardized checklist of Shiraz University of Medical sciences and Uribe questionnaire, the data were gathered from 10 public hospitals. Then, the data were entered into the SPSS statistical software (v. 16) and analyzed using descriptive statistics, Spearman, chi-square, one-way ANOVA, and T test. ] Results [During 365 days, 4379 medical errors were recorded in 10 hospitals. The highest frequency was related to systematic errors. Besides, most of the errors had occurred in larger hospitals, internal wards, and morning shifts. The results revealed a significant relationship between medical errors and wards and hospitals. Moreover, individual and organizational factors were the barriers to reporting medical errors in the study hospitals. Also, a significant correlation was observed between the medical errors reporting barriers and the participants’ job experiences (
The use of complementary and alternative medicines for hypertension: a summary of the Arab region
Get PDFWestern Australian Coastal Shark Bites: A risk assessment
Get PDFBackgroundAs Western Australia’s (WA) government enacts shark bite mitigation, the personal risk of shark bite in WA has not been studied.AimsModel the risk of large (>3m) white shark bite (Carcharodon carcharias, LWS) in southwest WA. MethodAn observational study inclusive of 1 January 1974 to 31 December 2013 was conducted. Analysis of prey abundance, location, water temperature, and water activity participation. Shark bite risk was benchmarked against serious or fatal recreational cycling crash risk in WA. ResultsTotal and fatal shark bites have grown exponentially over 40 years (3 to 29 total, 0 to 7 fatal per 5 years), correlated with the 10 per cent annual growth in WA humpback whale (Megaptera novaeangliae) abundance (rtotal=0.96 95%CI 0.77–0.99,
Factors associated with non-attendance in a general practice super clinic population in regional Australia: a retrospective cohort study
Get PDFBackgroundNon-attendance at medical appointments is associated with increased patient morbidity and is a significant drain on health service resources. Australian studies have focused on secondary healthcare settings, screening, and interventions to reduce non-attendance.AimsTo explore factors associated with non-attendance in a regional primary care setting.MethodA retrospective cohort of all patients with a scheduled appointment between October 2011 and October 2013 at a regional, primary care clinic providing medical and allied health services in a region of New South Wales (NSW) serving a large Aboriginal population (10.7 per cent). Using multivariate logistic regression, non-attendance was regressed on a range of covariates, including number of appointments per person, gender and ethnicity, and day of the week. ResultsThe overall proportion of missed appointments was 7.6 per cent. Risk factors for non-attendance were day of the week [Mondays (8.1 per cent), Fridays (8.0 per cent), and Thursdays (7.9 per cent), (χ2(4)= 20.208,
Quality of Patient Health Information on the Internet: reviewing a complex and evolving landscape
Get PDFBackground The popularity of the Internet has enabled unprecedented access to health information. As a largely unregulated source, there is potential for inconsistency in the quality of information that reaches the patient. Aims To review the literature relating to the quality indicators of health information for patients on the Internet. Method A search of English language literature was conducted using PubMed, Google Scholar and EMBASE databases. Results Many articles have been published which assess the quality of information relating to specific medical conditions. Indicators of quality have been defined in an attempt to predict higher quality health information on the Internet. Quality evaluation tools are scoring systems based on indicators of quality. Established tools such as the HONcode may help patients navigate to more reliable information. Google and Wikipedia are important emerging sources of patient health information. Conclusion The Internet is crucial for modern dissemination of health information, but it is clear that quality varies significantly between sources. Quality indicators for web-information have been developed but there is no agreed standard yet. We envisage that reliable rating tools, effective search engine ranking and progress in crowd-edited websites will enhance patient access to health information on the Internet. Key Words Internet; health; patient information; quality evaluatio
Ventilator-associated pneumonia
Get PDFBackgroundVentilator-associated pneumonia (VAP) is a type of nosocomial pneumonia that occurs in patients who receive mechanical ventilation (MV). According to the International Nosocomial Infection Control Consortium (INICC), the overall rate of VAP is 13.6 per 1,000 ventilator days. The incidence varies according to the patient group and hospital setting. The incidence of VAP ranges from 13–51 per 1,000 ventilation days. Early diagnosis of VAP with appropriate antibiotic therapy can reduce the emergence of resistant organisms.MethodThe aim of this review was to provide an overview of the incidence, risk factors, aetiology, pathogenesis, treatment, and prevention of VAP. A literature search for VAP was done through the PUBMED/MEDLINE database. This review outlines VAP’s risk factors, diagnostic methods, associated organisms, and treatment modalities.ConclusionVAP is a common nosocomial infection associated with ventilated patients. The mortality associated with VAP is high. The organisms associated with VAP and their resistance pattern varies depending on the patient group and hospital setting. The diagnostic methods available for VAP are not universal; however, a proper infection control policy with appropriate antibiotic usage can reduce the mortality rate among ventilated patients
Shprintzen-Goldberg syndrome presenting as umbilical hernia in an Indian child
Get PDFShprintzen-Goldberg syndrome (S-G) is a rare connective tissue disorder characterised by craniosynostosis, craniofacial dysmorphism, skeletal, cardiovascular, neurological, and other abnormalities. We herein present a case of a 5-year-old Indian child who presented to our clinic with reducible umbilical hernia since birth, mental retardation, and delayed developmental milestones. After meticulous clinical examination with subsequent integration of clinical findings and investigations, we diagnosed her to possibly have Shprintzen-Goldberg syndrome. An attempt to compare the findings of our index case with the classical features as described by Greally et al. has been made. Given the rarity of this syndrome and the paucity of medical literature measuring the magnitude of this condition in the Indian population, this case serves to promote awareness of this rare entity
An Unusual Right Popliteal Vein Aneurysm in an Adult: A Case Report
Get PDFThe incidence of venous aneurysm is less than arterial aneurysms. Most of them are incidental findings with no major clinical significance. However, popliteal vein aneurysms may be potentially life threatening as they can be a source of pulmonary embolism and potentially even death. We report a case of right popliteal vein aneurysm in a 67-year-old male cadaver. Information from this case study may contribute to an improved understanding of these phenomena, including early detection of these or similar thromboembolic events.