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  • ISSN: 2373-9819
    Volume 2, Issue 5
    Research Article
    Santhosh Gheevarghese John1*, Unnikrishnan Pillai2 and Philip B. Vaidyan3
    Abstract:
    Background: Urinary tract infections are one of the commonest nosocomial infections associated with increased morbidity and mortality as well as increase in health care cost. Catheter-associated Urinary tract Infections (CAUTI) play a pivotal role in nosocomial urinary tract infections. Lack of awareness among the physicians on the presence of Foleyscatheter in their patients multiplies the risk. The aim of the study was to asses' physicians' awareness of the presence of urinary catheters in their patients.
    Methods: This study was conducted in an urban community teaching hospital. We selected patients admitted to the hospital 72 hours prior to investigation and randomly assigned them based on the presence (n=88) or absence (n=175) of Foley catheter. Attending physicians for those patients were then asked about their awareness of the urinary catheter status in these selected groups of patients on the third day. Descriptive statistics were used to analyze the results. Outcomes of the presence of absence of catheters were not measured.
    Results: In the study group, 38% of physicians were not aware of the presence of Foleys catheter in their patients. Therefore, we can conclude that there is a significant lack of awareness of the presence of urinary catheter in patients among physicians involved in the study.
    Case Report
    Owain Davies*, Jeremy Batt, Rob Bethune and Edward Courtney
    Abstract:
    A 73 year old lady with a 3 day history of lethargy, vomiting, shortness of breath and bleeding per rectum was admitted 4 weeks following a laparoscopic cholecystectomy. CT imaging revealed a haematoma in the right upper quadrant that was demonstrated to be secondary to a right hepatic pseudoaneurysm (HAP). This was successfully embolized with the patient making a full recovery.
    HAP is a rare but potentially fatal complication of laparoscopic cholecystectomy. Several mechanisms are postulated to cause iatrogenic HAP formation with anatomical variation of the right hepatic artery a contributory factor. Early imaging in patients presenting with features of a bleed post laparoscopic cholecystectomy may prevent, potentially deadly, iatrogenic injury to a pseudoaneurysm if a laparoscopy is performed in the first instance.
    Jeremy Batt*, Rob Bethune, Owain Davies and Stephen Dalton
    Abstract:
    Acute gastric dilation is a rare but potentially fatal complication of all forms of abdominal surgery, but more so following fundoplication type anti-reflux procedures. In extremis it can progress to gastric necrosis and perforation but can easily be remedied by early insertion of a nasogastric tube for gastric decompression. This case demonstrates the need to consider acute gastric dilation as a cause of abdominal pain in a patient with a history of anti-reflux surgery 30 years previously.
    Monica L. Lypson1*, Alissa A. Weber2, Jennifer N. Stojan3 and R. Grant Rowe4
    Abstract: Primary infection with Coccidioides immitis occurs when fungal arthroconidia are inhaled and infiltrate the lung, causing a low-grade, usually asymptomatic infection in healthy individuals. After primary infection, invasive coccidioidal infections can rarely develop in immunodeficient or immunosuppressed individuals, involving various anatomic sites, including the skin, oropharyngeal mucosa, joints, and serosal surfaces, such as the pericardium. We report the case of an immunocompetent patient with a history of incompletely-treated disseminated coccidioidomycosis infection presenting with nephrotic-range proteinuria and renal insufficiency. While receiving therapeutic anticoagulation with heparin and warfarin for intravenous catheter-associated septic thrombophlebitis, the patient acutely developed a pericardial effusion with tamponade, likely secondary to subclinical coccidioidal pericarditis, which can often be asymptomatic. This report demonstrates that anticoagulation must be utilized judiciously in patients with a high likelihood of occult pericardial inflammation.
    Yu Shik Shim*
    Abstract: Venous varix occurring with a developmental venous anomaly is a rare disease entity that may be found incidentally by conventional cerebral angiography. Developmental venous anomaly (DVA) without venous varix has a normal physiology, and thus, in most cases treatment is not necessary. Although most varices with venous anomalies are known to be clinically silent but if hemorrhage from increased venous pressure or occurs, then a critical intracranial hemorrhage (ICH) may follow. But there is no guideline about conservative and surgical treatment. The authors present their surgical experience of 35-year-old man with a large venous varix occurring with DVA and rationale for surgical treatment.
    Clinical Image
    Yoshiya Watanabe, Yukiko Arisaka, Azusa Tokue, Takahito Nakajima* and Yoshito Tsushima
    A 41-year-old man affected by chronic renal failure and a long history of hemodialysis was admitted to our hospital for an 18F-fluorodeoxyglucos e-positron emission tomography (18F-FDG-PET) evaluation 3 months after undergoing surgery and chemotherapy for testicular seminoma. A computed tomography (CT) scan revealed diffuse hazy ground glass opacities in the central zones of the bilateral lungs. The 18F-FDG PET/CT scan also corroborated this finding as18F-FDG accumulated in these lesions.
    Shinichiro Asakawa, Masayuki Tanemoto*, Yosuke Kawamorita, Risa Okura, Yoshihide Fujigaki and Shunya Uchida
    Renal cortex-to-medulla blood flow redistribution is rarely observed on clinical images [1], and when observed, it could be taken as a sign of bilateral renal cortical necrosis, a rare form of acute kidney injury (AKI) [2]. We present a clinical example of redistribution.
    Alihan Oral*, Osman Kostek, Guralp Tasan and Ilyas Tuncer
    A 78-year-old man was referred to our department due to dysphagia, nocturnal choking and halitosis. Examination revealed malnutrition and cachexia. Upper GI endoscopy was decided due to suspected GI malignancy.
    Editorial
    Shalin S. Patel1, Mazyar Malakouti2, Maria D. Cortez1 and Robert J. Chilton1*
    Atherosclerotic vascular disease remains the leading cause of disease burden and mortality in the developed world. The complex interplay of genetics, nutrition, and environmental factors leading to atherosclerosis continues to attract great investigation.
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