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Jan 2026 DOI 10.14302/issn.2574-612X.ijpr-25-5920
The present study examines the effectiveness of Cognitive-Analytic Therapy (CAT) in women diagnosed with breast cancer and Post-Traumatic Stress Disorder (PTSD) on reducing PTSD symptomatology and improving their mental health state (depression, self-esteem, post- traumatic growth, quality of life, therapeutic alliance). Additionally, the investigation includes the determination of the demographic, socio-economic and medical factors’ impact on mental health indicators in women with breast cancer and PTSD. The sample was 188 women with breast cancer and PTSD at the Chemotherapy Unit of ‘Agios Andreas’ General Hospital in Patras. The questionnaire data were analyzed using descriptive and inferential statistical analysis in order to determine any statistically significant correlations between the experimental and the control group and between psychological scales and the demographic and socio-economic factors. The findings confirm the effectiveness of CAT in women with breast cancer and PTSD in reducing PTSD and depressive symptoms, improving self-esteem and quality of life, achieving greater post-traumatic growth, and fostering a better therapeutic relationship with the therapist. The demographic, socio-economic and medical factors examined affected dissimilarly each psychological scale, as statistically significant associations were found with some scales but not with others.
Nov 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5745
Background Healthcare worker stress, anxiety, burnout, and trauma have been widely documented across global healthcare systems. Staff in maternal and neonatal units frequently encounter emotionally distressing events and work under high pressure with limited resources. In Zambia, despite some gains in reducing maternal and neonatal mortality, fatality rates remain above national targets, exposing staff to repeated occupational trauma. Objective(s) This study aimed to assess the psychological well-being of staff in maternal and neonatal intensive care units, identify specific needs and stressors, and develop practical recommendations to improve resilience and support staff mental health. Methods A mixed-methods cross-sectional study was conducted at Ndola Teaching Hospital (NTH) and Arthur Davison Children's Hospital (ADCH), two major tertiary hospitals in Zambia. Data were collected over four days in February 2025. The study included 87 (out of 161) healthcare professionals, including nurses, midwives, and doctors. The Goldberg Anxiety and Depression Scale (GADS) and the Professional Quality of Life Scale Version 5 (ProQOL 5) were used to collect quantitative data, which were analysed using descriptive statistics and 95% confidence intervals (CI). Open-ended survey questions provided qualitative data, which were analysed using thematic analysis. Ethical approval was granted by the hospital ethics committee. Results High rates of clinical symptoms were observed. The overall prevalence of symptoms in the past 30 days was: anxiety (62%), depression (68%), burnout (50%), and secondary traumatic stress (46%). Junior doctors demonstrated the highest rates of depression (83%) and burnout (67%). The obstetrics and gynaecology and labour wards had the highest rates of secondary traumatic stress symptoms. Key qualitative themes identified were professional stressors, team and leadership issues, and the emotional burden of the work. Conclusion This study highlights an urgent need for both psychological and organizational support for maternal and neonatal healthcare staff in Zambia. The findings indicate that burnout and secondary traumatic stress are highly prevalent, particularly among junior doctors and those in high-risk wards. Targeted interventions at both systemic and individual levels are necessary to protect the well-being of healthcare workers and improve patient outcomes.
Nov 2025 DOI 10.14302/issn.2474-7785.jarh-25-5760
Commotio retinae (CR) is a condition frequently observed in clinical practice, particularly following closed globe trauma (CGT) due to sport, labor, or traffic accident injuries. It is the main cause of unilateral vision loss in male patients aged between. It is characterized by transient gray-white retinal coloration and reduction of visual acuity (VA). Symptoms depend mainly on the location and severity (deep) of the injury, with less complains when only the superficial or peripheral retina is affected. It may be confined to the posterior pole, when it is also called Berlin’s edema, after the first hypothesis of Berlin (1873). There is no specific treatment since the treatment depends on the region of the retina and choroid affected. In this work we report a case of Berlin edema, treated with ǪIAPI 1®, to restore the balance of oxygen, which is generated at the intracellular level.
Apr 2023 DOI 10.14302/issn.2694-1201.jsn-23-4385
Background Traumatic brain injury in pediatrics is one of the commonest causes of morbidity, disability and mortality worldwide. In low- and middle-income countries Study showed that death of pediatrics from traumatic brain injury was 7.3%. However, there is limited data towards the outcome of traumatic brain injury and its associated factors in Ethiopia. Objective To assess the outcome of traumatic brain injury and associated factors among pediatrics patients in Amhara National Regional State Comprehensive Specialized Hospitals, Ethiopia. Methods An institution based retrospective cross-sectional study was conducted among 423 pediatrics patients from January 1, 2019 to December 30, 2021, and data extraction period was from May 16 to June15, 2022. Systematic random sampling technique was employed to select the study participants. Data were collected from patient charts and registry books by using a data extraction tool. Data were entered into the Epi-info version 7 and analysis was done by SPSS Version 25. Both Bi-variable and multi-variable analyses were employed to identify factors associated with outcome of traumatic brain injury. Result From 423 sampled study participant charts 404 of them had complete information with response rate of 95.5% and included in the final analysis. The overall unfavorable outcome of traumatic brain injury at discharge was found that 12.13% (95% CI: 9.1% - 15.7 %). Sever traumatic brain injury (AOR: 5.11(CI :1.8-14.48), moderate traumatic brain injury (AOR:2.44(CI:1.07-5.58), Hyperglycemia (AOR: 3.01 (CI:1.1-8.04), sign of increased intracranial pressure (AOR:7.4(CI:3.5-15.26), and medical comorbidity (AOR: 2.65(CI:1.19-5.91) were predicted of unfavorable outcome of traumatic brain injury pediatrics patient. Conclusion and recommendations twelve present of traumatic brain injury results unfavorable outcome. Sever and moderate form of traumatic brain injury, hyperglycemia, signs of increased intracranial pressure, and medical comorbidity were factors associated with unfavorable outcome of traumatic brain injury in children. Therefore, it is preferable to improve accesses to acute and post-acute care services to lower the unfavorable outcome of traumatic brain injury in children.
May 2022 DOI 10.14302/issn.2997-1977.jd-22-4183
Temporal lobe meningoencephalocele is an uncommon anomaly in the face. As brain tissue herniate through the dural imperfection, cerebrospinal fluid (CSF) or a mass will appear in the mastoid, middle ear or the both. Here we present a 10 years old boy with right lobe temporal meningoencephalocele which results in CSF leakage and manifested with bacterial meningitis. He had a history of head trauma and bone fracture 3 years ago. In surgery the defect repaired and the patient showed improvement.
Sep 2020 DOI 10.14302/issn.2694-1201.jsn-20-3554
Background Traumatic brain injury is an expanding major public health problem and the leading cause of death of the young and productive part of the world’s population. Research is mainly done in high-income countries where only a small proportion of the worldwide fatalities occur. Only few studies have examined prognostic factors of traumatic brain injury outcome in developing countries including Ethiopia. This study was aimed at defining the peculiar demographic and other associated factors of traumatic brain injury (TBI) outcome among patients treated for head injury at Nekemte Referral Hospital. Objective The main purpose of this study was to describe the magnitude of TBI outcome and assess factors associated with unfavourable outcome of TBI among patients treated for head injury at the surgical side in Nekemte Referral Hospital from July 8, 2016 to July 7, 2018. Methods A retrospective cross-sectional document review was conducted among TBI patients treated for head injury from July 8, 2016 to July 7, 2018 at Nekemte Referral Hospital. Data were collected using a pre-tested data collection format. Data analysis was done using SPSS version 20. Descriptive statistics were computed and association between the dependent and independent variables were assessed by using logistic regression. Odds ratios with 95% confidence interval were computed. Significant association was declared when the p value was <0.05. Results In this study, out of 378 cases 95 (25.1%) were discharged with unfavourable outcome of which 37(9.8%) were neurologic deficits and 58 were deaths giving overall mortality rate of 15.3%. Patient age>60years (AOR: 15.13; 95%CI: 3.575-64.028), time interval from injury to treatment (AOR: 16.054; 95%CI: 5.832-44.194), low GCS (AOR: 18.224; 95%CI: 4.167, 79.695), conservative management (AOR: 20.774; 95%CI: 6.106-70.681), pupils abnormality (AOR: 9.078; 95%CI: AOR: 2.996-27.509) were associated with unfavourable outcome. Conclusions A quarter of patients treated for TBI at Nekemte Referral Hospital are discharged with unfavourable outcomes. Old age, delayed presentation to the hospital, low GCS, conservative management, and pupillary abnormality increase the odds of unfavourable outcome. Timely management of TBI before patients develop secondary brain injury and use of surgical intervention based on CT scan diagnosis will reduce the occurrence of unfavourable outcome.
Apr 2018 DOI 10.14302/issn.2766-6204.jmpt-18-2079
A review links maxillofacial trauma to psychological stress responses. It discusses screening, early interventions, and multidisciplinary care to improve recovery.
Jan 2018 DOI 10.14302/issn.2766-6204.jmpt-17-1898
An editorial outlines aims for the journal and offers practical tips to authors and editors on study design, reporting, and ethics in trauma research.
Sep 2017
Background: To evaluate cumulative dissipated energy (CDE), laser time, central corneal thickness and endothelial cell loss after two different fragmentation pattern by means of femtosecond laser-assisted cataract surgery (FLACS). Methods: Eighty eyes of 80 patients that underwent FLACS were randomized in two groups: mixed chop and dice lens fragmentation pattern (group 1 with 40 eyes) and mixed chop and cylindrical lens fragmentation pattern (group 2 with 40 eyes). Results: Cumulative dissipated energy was significantly lower in group 1 compared to group 2 (p<0.001). Postoperatively there was a decrement of endothelial cells count at the centre of the cornea in both groups compared with preoperative values with greater decrease in Group 2 (p<0.001). The thickness at the tunnel site showed a greater increase in group 2 compared to group 1 immediately after surgery (p<0.001) The thickness measured at the center of the cornea increased slightly immediately after surgery and showed a similar decrease in both groups. The increase was greater in Group 2 (p<0.001). Conclusions: Both lens fragmentation patterns were effective in nucleus disassembly. Nevertheless dice pattern was related with a lower amount of CDE and induced lower central endothelial cell loss and lower increase of corneal thickness.
Aug 2017 DOI 10.14302/issn.2574-612X.ijpr-17-1568
This study examined the mediating role of alcohol use in the relationship between PTSD symptoms and trauma-related psychotic reactions. A total of 231 participants including 181 females were recruited via web advertisement and flyers. Alcohol use condition, trauma-related psychotic experience, and PTSD symptoms were measured by Feeling the need to Cut down, Annoyed by criticism, Guilty about drinking, and need for an Eye-opener in the morning (CAGE), Psychosis Screening Questionnaire (PSU) and Short screening scale for posttraumatic stress disorder (SSSP). All the participants were asked to finish the questionnaire package on the Internet and were interviewed later to validate the screening. Logistic regression was used to estimate the mediating effect of alcohol use. Results showed that alcohol use played a mediating role between PTSD symptoms and auditory hallucination while this effect didn’t exist between PTSD symptoms and paranoia. Findings indicated that hallucination and paranoia in people with PTSD symptoms were influenced by alcohol use in diverse ways.
Apr 2017 DOI 10.14302/issn.2474-7785.jarh-17-1483
Background: Discharge disposition planning begins at admission and is frequently one of the first questions posed to healthcare providers by patients and families. We hypothesized that pre-injury functional status would predict discharge disposition. Methods: We linked prospective data from the Worcester, MA cohort of the Global Longitudinal Study of Osteoporosis (GLOW) study and the UMassMemorial Level 1 Trauma Center Registry to determine predictors of discharge disposition for female geriatric (over the age of 55) trauma patients using bivariate comparisons and multivariable modeling. Results: 154 women of 5,091 in the Worcester GLOW cohort were evaluated for traumatic injury at UMassMemorial and were discharged alive either to their home (n=30) or to rehabilitation, skilled nursing, or nursing home facilities (n=124). The mean age was 79 years and the majority (99%) was white. There were no statistically significant differences in comorbidities or injury severity score between the groups. All women with femur fractures were discharged to a facility. The most common injury among women discharged home was traumatic brain injury. While univariate analysis revealed differences in pre-injury activity status, only age remained statistically different in a logistic regression model predicting discharge to facility (OR 2.61 per additional 10 years of age, 95% CI 1.62 to 4.19, p<0.0001). Conclusions: The majority of elderly women are not discharged home after injury. Pre-injury activity status was not associated with discharge disposition when accounting for other factors. It appears that physical function, which deteriorates with age, is a proxy for aging in older women at risk for osteoporosis.
Dec 2025 DOI 10.14302/issn.2473-1005.jdoi-25-5870
This narrative literature review investigates the clinical feasibility of maxillary sinus lift using the lateral window (or traumatic) technique, employing a grafting material composed of hydroxyapatite associated with beta-tricalcium phosphate. The study is based on the premise that bone resorption and sinus pneumatization—common in edentulous posterior maxillae—pose a challenge to achieving primary stability during dental implant placement. Given the limitation imposed by reduced residual bone height, bone-grafting surgical techniques become necessary to enable implant-supported rehabilitation. The objective of this work is to analyze, through a literature review, the efficacy of combining synthetic biomaterials as an alternative to autogenous bone grafts, which are considered the gold standard in implant dentistry. A bibliographic search was conducted in the PubMed and LILACS databases and through the VHL portal, prioritizing articles addressing the biological properties of alloplastic grafts, the indications of the lateral window technique, and the clinical success rates of implants placed in previously grafted areas using such materials. The findings demonstrated that hydroxyapatite associated with beta-tricalcium phosphate exhibits favorable osteoconductive characteristics, such as adequate porosity and gradual resorption, while allowing the formation of viable bone within a clinically acceptable timeframe. The combination of these materials eliminates the need for a second surgical site, reduces morbidity, and maintains treatment predictability. It is concluded that the lateral window technique associated with synthetic biomaterials is a safe and effective alternative for patients with maxillary bone atrophy, capable of promoting suitable bone beds for dental implant placement and stabilization, with lower surgical risk and satisfactory clinical outcomes.
Dec 2025
The journey from personalized medicine to customized nutrition represents a significant paradigm shift in healthcare, emphasizing the holistic method for a person's or girl's well-being. in this transition, the know how of the unique genetic makeup , metabolic profile, and way of lifestyles elements of everybody will become paramount. customized medicinal drug has long centered on tailoring scientific remedies to the genetic and physiological traits of sufferers, optimizing efficacy, and minimizing detrimental effects. Now, custom-designed nutrients increase this idea further, recognizing that weight reduction plays an essential function in health and disease prevention. Key to this evolution is the mixing of advanced technology together with genomics, metabolomics, and microbiomics, allowing the suitable identification of dietary styles and nutritional requirements tailored to a person's particular desires. This summary explores the trajectory of this adventure, highlighting the pivotal characteristic of interdisciplinary collaboration among healthcare professionals, nutritionists, and researchers. With the useful resource of leveraging slicing facet generation and records-pushed strategies, personalized vitamins keep the promise of revolutionizing knowledge we method nutritional interventions, moving some distance from generalized guidelines towards targeted strategies tailored to all people's precise organic make up and way of life. expertise, traumatic conditions which include accessibility to this technology, ethical issues, and the desire for sturdy, proof-primarily based practices remain. In conclusion, the shift from customized treatments to personalized nutrient expertise is a transformative generation in healthcare, empowering people to take proactive management of their health through tailor made nutrition interventions. This summary underscores the importance of endured studies and collaboration in figuring out the entire functionality of personalized vitamins in selling health and well-being.
May 2025 DOI 10.14302/issn.2694-2283.jsem-25-5529
Background Septic arthritis is a potentially limb or life-threatening joint infection that requires prompt recognition and intervention to reduce morbidity and mortality. While intra-articular joint injections are commonly performed for osteoarthritis and other arthropathies, they carry a rare but significant risk of iatrogenic infection, particularly when performed in the presence of unrecognized joint or periarticular infection. Case Presentation We report a case of a 52-year-old female with a history of traumatic brain injury and chronic right knee pain who developed severe knee swelling, pain, and systemic symptoms following an intra-articular corticosteroid injection performed without ultrasound evaluation/guidance. Post-procedure, she presented with fever, elevated inflammatory markers, and purulent knee effusion. Operative washout revealed a purulent tract extending from the knee joint capsule to the lateral thigh. Cultures from joint aspiration and intraoperative samples grew Streptococcus dysgalactiae. Blood cultures were negative. The patient reported frequent cat scratches to the affected knee and described an unusual sensation of the injection needle tracking laterally during the joint injection. She was treated with surgical drainage and a four-week course of amoxicillin, with full clinical recovery. Discussion This case highlights an unusual presentation of septic arthritis with extra-capsular extension likely due to iatrogenic needle tracking during joint injection. The causative organism, S. dysgalactiae, is an uncommon pathogen in septic arthritis, and the presumed source was contiguous spread from untreated cellulitis, possibly related to cat scratches/bites. The absence of predisposing comorbidities and negative blood cultures further support a local rather than hematogenous source. The case emphasizes the importance of thorough clinical evaluation and consideration of infection prior to joint injections, as well as the potential benefits of ultrasound guidance to minimize procedural complications. Conclusion Careful history, physical examination, and appropriate imaging are essential prior to joint interventions to avoid iatrogenic complications. This case illustrates the rare but serious risk of extra-capsular extension of septic arthritis following intra-articular injection and emphasizes the need for vigilance in identifying underlying infection before proceeding with invasive procedures.
Aug 2024 DOI 10.14302/issn.2578-2371.jslr-24-5157
Introduction It was seen that splenectomy creates a disability situation in an individual, and in order to eliminate it, people applied to health boards to get a report to eliminate their social and economic losses recognized to them. Objective To examine the reason for surgery, method of surgery and the type of report they wanted to receive in splenectomised patients who applied to the general surgery committee polyclinic in 2017-2018-2019-2020 and 2023 when the pandemic ended. Materials and Methods Patients who applied to general surgery outpatient clinics were asked whether they had any surgery related to general surgery, and epicrises and pathology results of splenectomised patients were seen and recorded. Results Of the 23 splenectomised patients, 15 were female and 8 were male. Of the 15 female patients, 3 were splenectomised for ovarian ca, 3 for gastric ca, 2 for distal pancreatic ca, 2 for lymphoma, 1 for colon ca, 1 for traumatic cause, 2 for ITP, 1 for sarcoidosis. In male patients, 4 were splenectomised for traumatic, 1 for colon ca, 1 for ITP, 1 for thalassemia major and 1 for CML. The mean age of female patients was 48.1 years and the mean age of male patients was 37.4 years. The most common reason for splenectomy in women was malignancy and the most common reason for splenectomy in men was trauma. Conclusion Splenectomized patients had applied to receive the most DSR.
Feb 2024 DOI 10.14302/issn.2381-862X.jwrh-24-4918
Access to sexual and reproductive healthcare for sexual minority women is essential to fulfilling their human rights. This qualitative study was conducted in Rivers State, Nigeria, with fifteen participants as key informants. The study addressed the barriers to the sexual and reproductive healthcare needs of lesbians, bisexual women and sex workers in Port Harcourt metropolis. To address these barriers, the study answered the research questions on what access barriers prevent lesbians, bi-women, and sex workers from adequate utilization of sexual and reproductive healthcare services and common mental health issues sexual minority women experience. The study found that the barriers that prevent sexual minority women from accessing sexual and reproductive healthcare services include limited sexual and reproductive health information on available services offered by the health facilities, prejudice from healthcare providers and lack of social acceptance. Common mental health issues experienced as a result of these limitations are self-doubt over sexual orientation, trauma from threats, and parental pressure over marriage. To mitigate these barriers, the study recommends training healthcare providers on inclusive sexual and reproductive healthcare and to eliminate stigma and discrimination to improve access. Additionally, an improvement in laws and increased agency of sexual minority women to minimize negative mental health experiences. Finally, it also recommends creating a social group for sexual minority women to share experiences, support each other and learn about their sexual and reproductive healthcare will minimise barriers.
Oct 2022 DOI 10.14302/issn.2381-862X.jwrh-22-4228
Background Gender based violence (GBV) refers to any violence targeted at an individual or group on the basis of their gender. It could occur in different forms with several clinical manifestations. The authors have described several clinical manifestations of GBV in a tertiary health centre, knowledge of which would help in case identification and early clinical management. Methods Retrospective descriptive study of all clients seen at a gbv clinic over a sixteen months period.Data was obtained from case records and clinical presentations were entered into excel. Data analysis was done usingIBM SPSS Statistics for Windows, version 25. The results were presented in frequency tables and graphs Results Of 86 clients studied, 56(65.1%) were of pediatric age (< 18years) while 30(34.9%) were adults with a mean age of 18.33+11.64(range 1-64years).72(82.6%) belonged to the low social class. Physical abuse in the forms of battering, human bite, walking and sitting disturbances, hearing loss possibly from slapping or hitting and red eye possibly from trauma on the eye, constituted 37.6% of the clinical presentations. Other presentations were; sexual abuse in the form of forced sex which constituted 34.9%, while gynaecological / obstetrics presentations in the forms of bleeding per vagina, pregnancy due to forced sex and vaginal pain made up 13.9%. Emotional/psychological abuse was observed in all clients irrespective of their different presenting complaints. Conclusion While various forms of physical abuse were common, emotional abuse was present in all clients but masked probably due to prioritization of physical injuries. Therefore we recommend that all GBV survivors be screened for psycholocal abuse and psychotherapy given.
Mar 2022 DOI 10.14302/issn.2692-1537.ijcv-21-3757
Background The pandemic has disrupted the lives of many globally including persons with disabilities. These disruptions are universal. However, the vulnerable communities are more affected. Purpose The study examines impacts on persons with disabilities to share knowledge and inform interventions that ensure persons with disabilities are supported. Methodology The study is a systematic literature review using different search engines to search for scholarly articles all over the globe. Results Persons with disabilities have been negatively impacted in numerous ways: lack of access to healthcare services, inadequate rehabilitation services, increased human rights violation, stigmatization and discrimination, increased risk of dying, being subjected to violence, losing financial income, lack of access to education and treatment, increased in neglect and traumatization, poverty, lack of access to food, decreased in community support; and worse of all, in comparison with the overall population, the death of persons with disabilities during the Covid-19 is higher. These impacts were precipitated by inaccessible built environment and sense of touching, lack of disability sensitive policies, increased prevalence of risk factors, difficulties in adhering to WHO recommendations, pervasiveness of underlying health conditions, lack of disability-friendly information and inclusive intervention, national budget cuts; and poorly funded institutions. Conclusion Persons with disabilities have been negatively impacted due to many risk factors peculiar to them.
Aug 2021 DOI 10.14302/issn.2379-8572.joa-21-3913
This article has been retracted on 20 January 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-8572.joa-25-5850) Back ground and Objectives Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Therefore there are frequent premises regarding this procedure to be improved from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. Hence the tonsils and peritonsillar tissues are highly vascular zone that supplied by direct branches of external carotid artery thus the post-tonsillectomy bleeding remains one of significant issues in relation to this widely performed procedure. The post-tonsillectomy bleeding needs frequently to be postulated for its incidence, prevalence, etiology, predisposing factors, management and prevention. This subject constitutes one of most risky aspects that increase wariness of the surgeons regarding this commonly conducted procedure. Although there are huge numbers of presentative literatures coming from American as well as western institutes that tried to put guidelines for purpose of prevention and management of post-tonsillectomy bleeding but broadly at our middle-east region and locally at our Libyan society we found for some extent difficulties to apply all these guidelines. For this reason this issue has been take the wider spectrum of ENT surgeons’ concentration, discussions, and researches. Therefore this study was conducted prospectively and for long time to confirm the possible predisposing factors that could be responsible for increasing the risk of post-tonsillectomy bleeding at our region and in the same time to illustrate the concluded recommendations to prevent the occurrence of this important complication. Patients and Methods 2880 patients aged from 8 months to 85 years presented at ENT department-AL-hawari ENT and urology teaching center- Benghazi-city – Libya as well as AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city – Libya at period in between September 2003 to March 2015 as cases of chronic adeno-tonsillitis and solitary acute as well as chronic related palatine tonsillar disease with variable patterns of indications for tonsillectomy namely snoring and apnea attacks, recurrent attacks of acute tonsillitis, persistent otitis media with effusion, recurrent attacks of acute suppurative otitis media, failure to thrive, recurrent attacks of chest infection, mal-occlusive dental deformity, unilateral enlarged tonsils, post-traumatic avulsed tonsils, history of quinsy abscess and persistent halitosis. All patients were assessed intra-operatively and post-operatively too for any evidences of primary, reactionary, or secondary hemorrhage in relation to wide spectrum of factors as patient's demographic, medical, and socio-habitual factors, in addition to technical as well as post-operative care factors. Results This presenting study confirmed that the most common type of post-tonsillectomy bleeding was the secondary variety (71%) as compared to primary (22%) and reactionary (7%) among all presented post-tonsillectomy bleeding cases. Although through this presenting serial study there were multifactorial pre-dispositions elucidated for secondary post-tonsillectomy hemorrhage but as general poor post-operative care can be considered as the cornerstone for the pathogenesis of this significantly raised incidence of secondary post-tonsillectomy bleeding this may be in form of inadequate patient's hydration and nutritional supply (47%), poor patient's antibiotic compliance (23%), and child's maternal negligence (19%). The time of surgery was found to be another important pre-disposing factor for post-tonsillectomy bleeding, it was postulated that the incidence of reactionary as well as secondary post-tonsillectomy hemorrhage significantly increased at summer and autumn seasons (69%) as compared to other seasons. The place of surgery was another interesting proposed studied factor among this serial presentation it was observed that the incidence of post-tonsillectomy bleeding among patients who operated at AL-hawari ENT and urology teaching center-Benghazi-city significantly higher (63%) than that among cases who interfered at AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city. Conclusion Generally speaking, post-tonsillectomy bleeding is considered as one of important issues in ENT and one of significant post-tonsillectomy complications which may create a critical morbidity that may rarely extend to post-operative mortality. Hence the most common pattern of post-tonsillectomy bleeding is the secondary type; however this type of post-tonsillectomy hemorrhage is pre-disposed and induced by many factors. Most of these factors are treatable and curable thus the prophylaxis against this significant complication can be achievable.
Jul 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3885
Sepsis is a systemic inflammatory response to a confirmed or suspected infection. The transition from sepsis to septic shock causes high rate of mortality. The aim of this experiment was to evaluate the anti-inflammatory potential of the Biofield Energy Treated (Blessed) Proprietary Test Formulation and Biofield Energy Healing (Blessing) Treatment per se to Sprague Dawley rats on Cecal Slurry, LPS, and E. coli-induced systemic inflammatory response syndrome (SIRS) model. In this experiment, various proinflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, IL-10, IL-12, 1L-17, and interferon-γ (IFN-γ) were analysed using ELISA. A test formulation was formulated including minerals (magnesium, zinc, calcium, selenium, and iron), vitamins (ascorbic acid, pyridoxine HCl, vitamin E, cyanocobalamin, and cholecalciferol), Panax ginseng extract, β-carotene, and cannabidiol isolate. The constituents of the test formulation were divided into two parts; one section was defined as the untreated test formulation, while the other portion of the test formulation and three group of animals received Biofield Energy Healing Treatment remotely for about 3 minutes by a renowned Biofield Energy Healer Mr. Mahendra Kumar Trivedi. The level of TNF-α was significantly reduced by 40.50%, 85.36% (p≤0.01), 50.66% (p≤0.01), 87.38% (p≤0.01), and 58.63% (p≤0.01) in G5 (Cecal Slurry, LPS, and E. coli + Biofield Energy Treated test formulation), G6 (Cecal Slurry, LPS, and E. coli + Biofield Energy Treatment per se to animals from day -15), G7 (Cecal Slurry, LPS, and E. coli + Biofield Energy Treated test formulation from day -15), G8 (Cecal Slurry, LPS, and E. coli + Biofield Energy Treatment per se + Biofield Energy Treated test formulation from day -15), and G9 (Cecal Slurry, LPS, and E. coli + Biofield Energy Treatment per se animals + untreated test formulation) groups, respectively as compared to the disease control (G2) group. Additionally, the level of IL-1β was decreased by 17.04%, 15.56%, and 12.59% in G6, G8, and G9 groups, respectively as compared to the untreated test formulation (G4) group. The level of IL-6 was significantly (p≤0.001) reduced by 36.18%, 50.24%, 43.25%, 52.69%, and 38.23% in the G5, G6, G7, G8, and G9 groups, respectively as compared to the G2 group. The level of IL-10 was altered by 70.53%, 49.25%, 60.18%, 41.54%, and 58.89% in G5, G6, G7, G8, and G9 groups, respectively as compared to the G2 group. Moreover, the level of IL-12 was decreased by 30.24%, 31.67%, 29.82%, 45.77%, and 50.54% in the G5, G6, G7, G8, and G9 groups, respectively as compared to the G2. The level of IL-17 was reduced by 48.75%, 59.61%, 59.28%, 62.49%, and 58.65% in the G5, G6, G7, G8, and G9 groups, respectively as compared to the G2. IFN-γ expression was reduced by 49.56%, 24.09%, 23.7%, 56.98%, and 44.94% in G5, G6, G7, G8, and G9 groups, respectively than G2. Overall, the data suggested anti-inflammatory potentials of the Biofield Energy Treated test formulation and Biofield Energy Treatment per se along with preventive measure on the animal with respect to various inflammatory conditions that might be beneficial various types of systemic inflammatory disorders specially sepsis, trauma, septic shock or any types of injuries. Therefore, the results showed the significant slowdown the inflammation-related disease progression and its complications in preventive treatment groups viz. G6, G7, G8, and G9.
Jan 2021
Small extra-peritoneal bladder injury is commonly treated conservatively as it heals spontaneously. However if there is an impinging bony spicule in the rent, the bladder wound does not heal and it is preferable to repair the rent primarily. We present a case of non healing extra-peritoneal bladder injury initially managed conservatively in a trauma center with supra-pubic catheter (SPC). Cystogram was done after 7 weeks showed persistent leakage of contrast. Hence patient was managed by laparoscopic repair of persistent extra-peritoneal bladder rent.
Dec 2020 DOI 10.14302/issn.2470-5020.jnrt-20-3629
Introduction The extra dural hematoma is a blood collection between the cranial vault and the dura mater. It is a neurosurgical emergency whose statistical data are poorly known in the Republic of Benin. Objective The aims of this study are to assess epidemiology, therapeutic and outcome of traumatic extra dural hematomas for children admitted to the surgical department of CHUD-B/A from 2012 to 2017. Methods This was a cross-sectional, descriptive and retrospective study over a period from January 1st, 2012 to December 31st, 2017. Results One hundred and seventy-eight cases of children aged between 0-15 years were examined for brain traumatic injury. Twenty-seven 27 (15.2%) cases of extra dural hematomas were retained. The most represented age group was between 11-15 years with a frequency of 42.1%. The male sex was more represented (78.9%). Road traffic accidents were the main aetiology (57.9%). 52.6% had a mild head injury, 26.3% had a moderate head injury and 21.1% had a severe head injury. On brain scan the frequently observed location was temporo-parietal (31.6%). Acute anemia was observed in 16 children. Seventeen children were operated on. The operation involved evacuation of extra dural hematoma by cranial bone flap with suspension of the dura mater. There were no deaths. Conclusion The availability of brain CT makes the diagnosis of extra dural hematoma easier. Its management is neurosurgical with a favourable post-operative evolution in all cases in this series.
Aug 2020 DOI 10.14302/issn.2574-612X.ijpr-20-3491
Climate change is a global challenge which is likely to affect the mankind in substantial ways. Not only climate change is expected to affect physical health, it is also likely to affect mental health. Increased frequency of disasters with climate change can lead to posttraumatic stress disorder, adjustment disorder, and depression. Changes in climate may require population to migrate, which can lead to acculturation stress. It can also lead to increased rates of physical illnesses, which secondarily would be associated with psychological distress. Using a qualitative approach, this research explores the mental health status of migrant women in two urban slum areas in Dhaka city. The purpose of this study is to perform a review of existing secondary data and present mental health scenario of climate migrant women among slum dwellers and amplified gaps in knowledge regarding psychological health care system in Bangladesh. It is found that there is a lack of mental health preparedness and response in majority parts in the country specially the city slum, where aid cannot be reached to the sufferers. The paper concludes with a discussion of what can and should be done to tackle the expected mental health issues consequent to climate change and migration.
Jun 2020 DOI 10.14302/issn.2578-2371.jslr-20-3371
We hereby report a scrotal epidermoid cyst presenting as a scrotal mass which a rare entity in the absence of trauma. 36years old male presents with a complaint of left sided testicular swelling and discomfort. The workup included clinical examination, alpha-fetoprotein (αFP) and beta-human chorionic gonadotropin (β-hCG) analyses and scrotal ultrasound. Clinically confused as testicular malignancy. Complete surgical excision of the cyst was performed. Histopathology confirmed epidermoid cyst with no evidence of malignancy.
May 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3367
We explore the global evidence of major health crisis potential impacts and the factors influencing the mental health outcomes among the population during the outbreak of COVID-19. Preparation measures for a COVID-19 focus on rapid quarantine of social isolation and economic concerns have risen metal health considerations that become an integrated part of the pandemic outbreak. This outbreak of novel Coronavirus disease (COVID-19) pandemic is swayed an overall 213 countries, areas or territories, with over 2,921,439 confirmed cases and 203,289 confirmed deaths reported till 26 April 2020. This created a lot of strain and fear; fear of falling ill and dying of being infected leading to heightened levels of insurmountable psychological pressure. This scrutiny attempt to assess the widespread outbreaks of COVID-19 on mental health professionals, healthcare workers and general population in association with adverse mental health sequelae like generalized anxiety disorder (GAD), depressive symptoms, insomnia, panic attacks, post-traumatic stress disorder, OCD, suicidal behavior, delirium, psychosis, harmful alcohol consumption, and drug use. There is a need for more evocative exploration to intensify awareness to address the potential psychological and behavioral risks that will remain elevated as long as the COVID-19 pandemic continues in the community. In conclusion, incessant surveillance of the subsyndromal mental health problems for outbreaks should be part of galvanized global action during the quarantine.
Jun 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2750
Purpose Foot injuries are common in low- and middle-income countries and continue to increase in incidence due to the surge in the use of motorcycles as means of transport.Yet, there is scanty data on the incidence and outcomes of treatment of open injuries to the foot in the developing world.We aimed to determine the incidence and functional outcomes of open foot injuries that are treated in a teaching hospital in Ghana. Methods We used a structured questionnaire to record the type of open foot injury, the mechanism of injury, any concomitant injuries, the time interval between injury and arrival at the hospital for treatment as well as the type of treatment instituted. Recruited patients were followed up for six months, complications resulting from the injury or its treatment were recorded for each patient. The function of the foot after healing of the injury was measured using a questionnaire-based visual analogue outcome scale of the American Foot and Ankle Society. Regression and chi-square analysis were used to evaluate potential associations. Results Over a four-month period, a total of 81 cases of open injuries to the foot were recorded. Out of this figure, 55 patients (67.9%) were males and 26 (32.1%) were females. It was found, that 66.7% aged between 19 and 49 years, 76.5% of the injuries occurred on the road and 29.7% was motor cycle related. Pedestrians are the most afflicted (61.7%). The treatment outcomes of traumatic amputations, open phalangeal fractures, dorsal skin degloving and lacerations were good. Gustillo-Anderson grade IIIB open fractures with associated plantar skin degloving had the worst outcomes with residual pain on weight bearing, bigger foot, inability to wear previous shoes and inability to tiptoe on the affected foot. Conclusions Open injuries to the foot are common in Ghana and exert a significant health burden, particularly on active young males. Long term disability may occur, even after adequate treatment of open fractures involving the foot.
Apr 2019 DOI 10.14302/issn.2643-6655.jcap-19-2737
Background Mothers with a history of childhood maltreatment (CM) are likely to transmit their own experiences to the next generation. This is highly influenced by the quality of maternal behavior that enables to buffer infant’s hypothalamic-pituitary-adrenal (HPA) axis response to stress. From a transgenerational perspective the research question is, if infant’s cortisol stress response is influenced by maternal CM experiences or rather by the behavioral pathways during the first year of life. Methods 53 mother-child-dyads were measured at 12 months of infant’s age in a laboratory visit assessing the maternal quality of interactive behavior using the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE) measured during the strange situation procedure (SSP). Maltreatment experiences were assessed using the childhood trauma questionnaire (CTQ). Salivary cortisol of mother and infant were collected prior to and directly, 15 and 30 minutes after the SSP. Results Infants of disruptive mothers showed a significant increase in cortisol (F (3; 147) = 2.897, p= 0.048) after the SSP compared to infants of mothers with sensitive caregiving. Maternal CM did not influence the infant’s cortisol stress response due to the SSP. However maternal cortisol response was altered by trend due to CM (F (1.392; 71.008) = 3.157, p= 0.066). Conclusions Our data indicate that infant’s cortisol stress reactivity is influenced by the quality of maternal behavior and not by the transgenerational transmission of maternal CM experiences per se. These findings implicate that helping mothers to improve their caregiving behavior may help to improve stress-reactivity of their infant.
Apr 2019 DOI 10.14302/issn.2640-690X.jfm-19-2725
Background Romantic partners living alongside veterans with Post Traumatic Stress Disorder (PTSD) appear at increased risk of secondary traumatic stress (sPTSD) and common mental health difficulties (CMD) compared to the general population. The severity of symptoms implies the need for structured, bespoke and evidence-based interventions. Objective The aim of this study was to explore the feasibility of offering a community support programme (The Together Programme, TTP) for military partners. TTP was developed based upon a number of US programmes and consisted of 10 hours of group-based support delivered over a five-week course. 56 participants engaged in TTP over a year at nine locations across the UK and were followed up three months later. Methods Measures of CMD, sPTSD, alcohol use and relationship satisfaction were used to assess benefits. Data were also collected on attendance and participant feedback. Results Significant reductions were observed for symptoms of sPTSD and CMD at follow up. 51/56 (90.1%) participants completed TTP. The majority of participants reported positive experiences. However, several individuals stated wanting more sessions and that barriers such as work, and family commitments made it difficult to attend. Conclusions Whilst limitations exist, the data presented suggests cautious optimism for the efficacy of offering a structured programme of support to address the needs of military partners living alongside PTSD.
Mar 2019 DOI 10.14302/issn.2640-690X.jfm-19-2726
Background Research has demonstrated that partners living alongside veterans with mental health difficulties are at high risk of developing mental health difficulties themselves and secondary trauma. A variety of interventions have been developed to support partners. Research to date has relied on quantitative methodologies to evaluate the efficacy of such interventions with less emphasis on learning about the experiences of individuals on the courses. Objective The aim of this qualitative paper was to understand the experiences of partners who engaged in a five-week structured support intervention, ‘The Together Programme’ (TTP) which had been piloted across UK cities. This programme involved tailored psycho educational materials adapted to the needs of veteran’s partners living alongside PTSD. Further the potential mechanisms of change for participants engaged with the programme were explored as well as the impact of treatment on their relationships. Methods Eight female partners were recruited from an original sample of 57 partners who were intimate relationships with treatment seeking veterans with mental health difficulties. These participants had completed TTP. Qualitative data was collected using a semi structured interview and explored using Interpretative Phenomenological Analysis. Results Three key themes emerged from the data, these were self-growth, changing role in relationships and connecting with others. The themes included several sub themes. Self-growth sub-themes were mastering the ‘inner judge’, ‘confidence in ability to cope’ and ‘taking care of my needs’. Changing role in relationship sub-themes were ‘acceptance and understanding’ and ‘improved communication in relationship’. Connecting with others was described by the sub-themes of ‘knowing I am not alone’, ‘peer support’ and ‘hope’. Conclusions This study suggeststhere were three key areas where thestructured evidence-based support programme had an impact on participants experiences. These were factors that helped participants to normalise their experiences and increase participants understanding and interpersonal skills that promote changes in relationship functioning with the veteran.
Aug 2018 DOI 10.14302/issn.2574-612X.ijpr-18-2246
The psychiatric disease of dissociative amnesia is described and illustrated with case reports. It is emphasized that dissociative amnesia has a stress or trauma-related etiology and that affected individuals, contrary to the still dominant clinical belief, are frequently more severely and enduringly affected. That means, most of them show severe retrograde amnesia for their biography, usually accompanied by changes in their personality and sometimes also by alterations in other cognitive and emotive domains. As many patients show the phenomenon of “la belle indifference”, their motivation for therapy or treatment of their amnesia is reduced. Patients also seem to a high degree to possess immature, unstable personality features. Nevertheless, a number of quite divergent, though largely not evidence-based, therapeutic approaches exist and are described. They are divided into (a) psychopharmacological and somatic treatments, (b) psychotherapeutic interventions, and (c) neuropsychological rehabilitation. Furthermore, detailed treatment strategies are provided.
Jun 2018
Objectives: Torture survivors suffer psychosocial distress such as posttraumatic stress disorder (PTSD) and depression. Patients with PTSD and depression have increased risk for suicidal behavior. The aim of this study is to identify those torture and war survivors who have suicidal thoughts and describe their psychological profile as assessed in SCL-90-R. The patients of the Swiss Red Cross Centre for Torture Victims receiving psychotherapy were monitored with the SCL-90-R (N=58). Results: Out of 56 patients 32 (57%) declared that they did not suffer under the thought to end their own life (0=not at all), 10 (18%) indicated that they suffered substantially (scale value 3) or extremely (4) while 14 (25%) suffered somehow (1, 2). The endorsement of the suicide ideation correlates highly with all SCL-90-R scales, particularly with the scale Depression and PTSD indicating that the patients with suicide ideation also show considerable psychopathology. The scale Depression explained 40% of the variance of the suicide thoughts item and the scale Anger-hostility added another 5%. Conclusion: Suicide prevention should be an important part of the treatment and care in dealing with war and torture survivors.
Jun 2018 DOI 10.14302/issn.2574-612X.ijpr-18-2110
Purpose: There are nearly 170,000 new cases of breast cancer in China every year, and this number is showing an increasing trend. Mental health plays an important role in promoting the physical rehabilitation of patients. Therefore, attention paid to their psychological problems needs to be reinforced. The current study aims to investigate the mental health states of the breast cancer patients and provides the references for their psychosomatic rehabilitation in the future work. Methods: A total of 643 breast cancer patients completed the whole study. A questionnaire survey on anxiety, depression, posttraumatic stress disorder (PTSD), and posttraumatic growth (PTG) was conducted in Jiangsu Women and Children Health Hospital. Results: 13.53% breast cancer patients had anxiety; 21.5% had depression; the prevalence of PTSD was 7.15%, while the prevalence of PTG was 26.12%; Anxiety levels in older patients were significantly lower than those in the other two groups; PTG levels in older patients were significantly lower than those in the other two groups. Conclusion: Breast cancer patients have certain emotional distress and stress symptoms, but they also experience psychologically positive changes. And age shows various differences on anxiety and PTG. Clinical medical personnel should pay attention to the patient's psychological rehabilitation when concerning about the physical rehabilitation of patients. Patients in different ages have different mental health problems, thus the medical staff shall provide differential nursing plans for them.
Feb 2018 DOI 10.14302/issn.2576-6694.jbbs-18-1887
The application of bilateral alternating stimulation in tactile (BLAST) form technology, a non-invasive, somatosensory-based method, has been shown to modulate the electrical activity of brain networks that mediate the stress response, resulting in a stress-reducing effect in individuals with high reported levels of anxiety, such as post-traumatic stress disorder (PTSD). In this study, we examined archival data from a heterogeneous group of users (n = 1109) of BLAST technology via Touchpoints, a novel BLAST-based treatment modality, all of whom had high self-reported levels of stress and anxiety. Ratings of levels of emotional stress and bodily distress on a scale of 0 (no stress/distress) to 10 (worst stress/distress of one's life) before and after the application of Touchpoints for 30 seconds were entered into an app. Results showed a statistically significant reduction in the levels of both emotional stress and bodily distress, 62.26% and 50.502%, respectively, after 30 seconds of BLAST technology was applied. This demonstrates a clear benefit of BLAST on the stress response, reducing both emotional stress and disturbing body sensations. Recent work examining EEG changes after BLAST technology is applied suggests that BLAST may reduce sympathetic activation by reducing the electrical activity of key areas of the salience network. Further work will more precisely characterize the effects of BLAST, its potential clinical uses, and the mechanisms of actions behind it’s apparent stress-reducing effects.
Jan 2018 DOI 10.14302/issn.2578-8590.ipj-17-1910
Following ocular trauma and retinal detachment, gliotic changes in the retina may develop over the subsequent month, a process known as PVR (proliferative vitreoretinopathy). There have been no successful therapeutic interventions to inhibit PVR. The protein CTGF (Connective Tissue Growth Factor) has been associated with retinal PVR and other fibrotic diseases of the retina in clinical studies but the mechanistic link between different pathologies and retinal gliosis has not been determined. In addition, CTGF has been previously noted to be associated, in some cases, with YAP/TAZ (Yes-associated protein and Tafazzin protein complex), transcriptional regulatory proteins that change subcellular localization in response to mechanical cues, such as the stiffness of the underlying material. We have previously shown that the mRNA for CTGF is markedly (100-fold) upregulated in retinal Müller cells grown on soft substrates. In order to evaluate if the mechanism by which mechanotransduction modulating CTGF production in retinal Müller cells involves the YAP/TAZ complex, this study tests the influence of substrate stiffness on the time dependence of CTGF protein expression, as well as subcellular localization of YAP/TAZ using a conditionally-immortalized mouse retinal Müller cell line plated on laminin-coated, polyacrylamide substrates of varying elastic modulus. Changes were assayed using immunohistochemistry and ELISA (Enzyme-Linked ImmunoSorbent Assay). In retinal Müller cells, the relationship between elastic modulus and the pattern of CTGF protein expression was bimodal, with CTGF levels rising more rapidly for cells on hard substrates and more slowly for cells grown on soft substrates. In addition, nuclear localization of YAP/TAZ corresponded directly to the maximum CTGF expression.
Sep 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1189
Objectives: This pilot study explored post-traumatic stress symptoms (PTSS) and moderate to severe psychological distress in a small sample of urban community-living adolescents seeking asylum in Australia. The study also examined the relationships between post-traumatic stress symptoms (PTSS) and psychological distress and school and family support and connectedness. Method: A cross-sectional survey examined PTSS (Abbreviated PTSD Checklist), psychological distress (Kessler-5) and school connectedness (California Healthy Kids Survey)53 in 27 adolescents seeking asylum (ages 12-17, mean 15.4) attending two independent secondary schools in Perth, the capital city of Western Australia. Results: In the sample, 63.0% (n=17, 1 missing) of adolescents exceeded the PTSS threshold (i.e. screened positive for Post-traumatic Stress Disorder) and 66.7% (n=18) exceeded the Kessler -5 threshold indicating moderate to severe psychological distress. Overall, 51.9 % (n=14, 1 missing) of adolescents screened above both thresholds suggesting co-occurrence of PTSD and moderate to severe psychological distress. Boys (x̄=15.0, SD=2.9) experienced higher psychological distress scores than girls (x̄=12.1, SD=4.5; p=0.071). Higher perceived support by an adult in school (r=0.13), and at home (r=0.28) were weakly associated with lower PTSS. Less time in Australia was weak-moderately associated with higher psychological distress (r=0.35). Weak associations between higher psychological distress and age (r=0.17) and those who felt more supported by an adult at home (r=0.17) were detected. Conclusion: Approximately two thirds of this group of community-living adolescents who were seeking asylum experienced post- traumatic stress symptoms or psychological distress; and more than one half experienced both. These pilot research findings suggest that adolescents who are seeking asylum and living in the Australian community are at risk of experiencing PTSD and moderate to severe psychological distress; research incorporating larger samples and longitudinal measurement is required. Screening, clinical assessment and examination of the immediate and long term impact, as well as implementation and evaluation of evidence-based mental health interventions, within these populations is also recommended.
Sep 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1146
Introduction: Cemento-ossifying fibroma is is a reactive lesion arising from the soft tissues (gingiva). Case report: A 13-year-old boy presented with the complaint of lump in mandibular right posterior region on the lingual side since a month. The patient presented no symptoms and had no medical history of interest. The lesion was excised and submitted for histopathological evaluation, which gave a diagnosis of peripheral cemento-ossifying fibroma. Discussion: Periheral Cemento-ossifying fibromas are slow-growing lesions, and are more frequent in women between the second and third decades of life. Although the underlying cause is not known, there have been reports of the lesion developing after irritation/ trauma in the concerned area. Due to the good delimitation of the tumor, surgical removal and curettage is the treatment of choice.
Aug 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1151
Oxidative stress mediated neural cell death is thought to be involved in the progression of secondary cell injury following brain trauma. Agents that can block oxidative stress-related injury could be potential therapies for TBI. Resveratrol, a polyphenol found in plants and red wine, is cytoprotective due to its potent antioxidant activities. To further understand how resveratrol could affect oxidative stress-induced injury, we hypothesized that the cytoprotective activities of resveratrol could be dose-dependent. In this study, resveratrol-induced cytoprotection was evaluated in cultured astrocytes. Primary rat astrocytes were cultured in T-75 flasks to a confluence of 80% before being plated onto 96-well plates. After 24 hours of acclimation, astrocytes were treated with various doses of hydrogen peroxide (H2O2) (0.1, 0.25, 0.5 and 1 µM) and resveratrol (25, 50, 75, 100 µM), respectively. Cell viability was determined 24 hours later using Alamar Blue Assay. Treatment of astrocytes with 0.5 mM H2O2, left 65% of astrocytes non-viable whereas treatment of astrocytes with 0.1 mM H2O2 had no effect on astrocytes viability; whereas 1 mM, H2O2 caused total loss of astrocyte viability. Resveratrol treatment at 75 µM and 100 µM has reduced 0.5 mM H2O2-induced cytotoxicity in astrocytes by 50%. Immunostaining with GFAP also confirmed these findings about the cytoprotective effects of resveratrol in astrocytes exposed to H2O2. These results suggest that resveratrol could be a potential neuroprotective agent in TBI due to its antioxidant properties. Further studies are needed to evaluate the long- term effects of resveratrol in animal models of TBI.
Jul 2016 DOI 10.14302/issn.2471-7061.jcrc-14-575
Aim: To analyze the factors involved in and the results of stoma reversal after an emergency Hartmann's operation. Methods: A multicenter retrospective study from the Valencian Society of Surgery of patients who had undergone an emergent Hartmann’s operation from 2004 to 2008. An analysis of the reversal rate and related factors, delay, and morbidity of reconstruction was performed. Results: Three hundred sixty-two patients were studied. The most frequent initial diagnosis was colorectal cancer, followed by complicated acute diverticulitis; the primary surgical indication was acute peritonitis. After a median follow-up of 52 months, 151 patients (41.7%) underwent surgery to reverse the stoma at a median of 10 months after initial surgery. Diagnosis of diverticulitis or trauma, peritonitis as the surgical indication, and non-advanced tumors were associated with reversal. Multivariate analysis showed that only age and tumor stage were predictive of reversal. Postoperative complications occurred in 44% of the cases, and wound infection was the most common. There were 9 (6%) anastomotic leaks. Thirteen patients (8.6%) retained a permanent or temporary stoma after the attempted reconstruction. Conclusion: Hartmann’s reversal after emergency surgery is performed in less than half of all such patients and has significant morbidity.
Jun 2016 DOI 10.14302/issn.2471-7061.jcrc-14-579
Enteroatmospheric fistula is a challenging and emerging clinical situation, mainly related to “open abdomen” technique in damage control surgery for trauma and in case of multiple laparotomies. We report the case of a 61-year-old male patient, affected by rectal carcinoma, submitted to standard surgical treatment and gradually evolving in persistent proximal jejunal fistula. The positioning of a cardiac septal occluder (Amplatzer®) was associated with immediate and late favourable effects. The procedure was conducted “bed-side” and turned out to be easy and safe.
Aug 2015 DOI 10.14302/issn.2372-6601.jhor-15-666
Objectives: To clarify the role of trace elements in the etiology and the pathogenesis of the chondrosarcoma, a non-destructive neutron activation analysis with high resolution spectrometry of long-lived radionuclides were performed. Methodology: The silver (Ag), cobalt (Co), chromium (Cr), iron (Fe), mercury (Hg), rubidium (Rb), antimony (Sb), selenium (Se), and zinc (Zn)mass fractions and Co/Zn, Cr/Zn, Fe/Zn, Hg/Zn, Sb/Zn, Co/Rb, Cr/Rb, Fe/Rb, Hg/Rb, Sb/Rb, and Se/Rb mass fraction ratios were estimated in normal bone samples from 27 patients with intact bone (12 females and 15 males, aged from 16 to 49 years), who had died from various non bone related causes, mainly unexpected from trauma, and in tumor samples, obtained from open biopsies or after operation of 16 patients with chondrosarcoma ((3 females and 13 males, 8 to 65 years old). The reliability of difference in the results between intact bone and chondrosarcoma tissues was evaluated by Student’s t-test. Key Results: In the chondrosarcoma tissue the mass fractions of Co, Fe, and Se are significantly higher while the mass fraction of Rb is lower than in normal bone tissues. Moreover, significantly higher Co/Zn, Fe/Zn, Co/Rb, Cr/Rb, Fe/Rb, Sb/Rb, and Se/Rb mass fraction ratios are typical of the chondrosarcoma tissue compared to intact bone. In the chondrosarcoma tissue many correlations between trace elements found in the control group was no longer evident. Major Conclusions: In chondrosarcoma transformed bone tissues the trace element homeostasis is significantly disturbed.