ABSTRACT
BACKGROUND: The management of complex pattern of bleeding associated with pelvic trauma remains a big chalenge for trauma surgeons. We aimed to conduct a comprehensive meta-analysis to compare the outcomes of angioembolisation and pelvic packing in patients with pelvic trauma. METHODS: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; the CENTRAL; the World Health Organization International Clinical Trials Registry; ClinicalTrials.gov; ISRCTN Register, and bibliographic reference lists. The primary outcome was defined as mortality. Combined overall effect sizes were calculated using random-effects models. Results are reported as the odds ratio (OR) and 95％ confidence interval (CI). RESULTS: We identified 3 observational studies reporting a total of 120 patients undergoing angioembolisation (n=60) or pelvic packing (n=60) for pelvic trauma. Reporting of the Injury Severity Score (ISS) was variable, with higher ISS in the pelvic packing group. The risk of bias was low in two studies, and moderate in one. The pooled analysis demonstrated that angioembolisation did not significantly reduce mortality in patients with pelvic trauma compared to surgery (OR=1.99; 95％CI= 0.83–4.78,P=0.12). There was mild between-study heterogeneity (I2=0％, P=0.65). CONCLUSION: Our analysis found no significant difference in mortality between angioembolisation and pelvic packing in patients with traumatic pelvic haemorrhage. The current level of evidence in this context is very limited and insufficient to support the superiority of a treatment modality. Future research is required.
ABSTRACT
Objective: We assessed the knowledge level and skills of trained ASHAs in providing home-based newborn care. Methods: 100 ASHA from two talukas of Anand district of Gujarat participated. Knowledge was assessed using a structured questionnaire while certain skills were assessed through direct observation on mannequins. Results: The mean (SD) knowledge score of the participants was 16.7(3.16) out of 34. The skills were satisfactory in 52%, 61%, 43%, and 68% of ASHA workers for temperature measurement, hand washing, weight measurement and skin-to-skin care, respectively. Large variability was observed in self–reported and field performance of ASHA workers. Conclusions: Knowledge and skills of Asha workers in this region were inadequate.
ABSTRACT
Angioimmunoblastic lymphadenopathy (AILD) is a rare condition, which is difficult to diagnose as it mimics tuberculosis or lymphoma both clinically and radiologically. A case of AILD with pulmonary involvement that was initially mistaken for tuberculosis on fine needle aspiration cytology and put on antituberculous treatment for three months, is presented here. The case was subsequently diagnosed to lymph node biopsy as one of AILD.