ABSTRACT
Background: The need for research into bed sores in orthopedic patients is evident from the increased number of beds they occupy and the considerable morbidity from pressure sores in orthopedic wards. Objective: To analyze and ascertain the prevalence and clinical evaluation of Pressure Ulcers from orthopedics wards of a tertiary care teaching hospital. Material and methods: The present prospective study was conducted by the Department of Orthopedics of a tertiary care teaching hospital from July 2009 to August 2014 among 228 patients seeking care for trauma to proximal femur, hip joint, pelvis and undergone elective surgery or surgery for removal of old implants. Braden scale was used for predicting pressure ulcers in the study subjects. All patients showing the potentiality of developing clinical signs of bed sores were selected and put on the study list. Patients aged ≥ 80 years, sick patients due to terminal illnesses and the worst pressure sores were excluded from the study. Results: Out of total 228 study subjects, 61 subjects developed pressure ulcers giving a prevalence of 26.75%. According to Braden Scale, 16.39% of patients were at high risk for developing the pressure ulcers. 68.85% of ulcer patients were treated for trauma mostly for fracture hips, pelvis or proximal femur or spine. Majority of patients (60.66%) developed pressure ulcers after the second week of admission. The lengths of stay of patients with bed sores exceed the stay of non sores patients on orthopedic wards by several times. Sacrum was the most commonly affected part of body. Conclusion: The findings of the current study highlight the multi-factorial etiology of pressure ulcers and they are preventable. Its prevention would require multidimensional approach including the collaboration of all the nursing and surgical staff. Frequent patient turning, close monitoring and frequent skin checks would delay the onset of pressure ulcers.
ABSTRACT
Congenital diaphragmatic hernia is a rare entity occurring in 1 in 2000-4000 live births and accounts for 8% of all major congenital anomalies. Congenital diaphragmatic hernia (CDH) is a major surgical emergency in new-borns because the key to survival depends on the prompt diagnosis and treatments. We reported here a case of right sided congenital diaphragmatic defect with liver hernia in a 7 month old baby, who came to seek medical care at a tertiary care centre in Navi Mumbai for on and off cold and cough with breathlessness after feeds. The baby was tachypneic on examination. Immediately chest X-ray and CT scan of thorax and abdomen was done to assess symptomatically and clinically suspected case of congenital diaphragmatic hernia. It was a case of right sided congenital diaphragmatic hernia.