ABSTRACT
@#A bent intramedullary (IM) nail becomes challenging and technically demanding to the orthopaedic surgeon for nail extraction. A broken nail can be easily removed through the fracture site. However, a bent nail has to be broken before it can be removed. Several studies and case reports outline the strategies and techniques for removing a bent IM nail. However, there is a paucity of guidelines and standard protocol describing the best and inexpensive strategy. We report a case where two years following surgery for intramedullary nailing of the right femur, the IM mail was bent following secondary trauma. We used a technique based on the principles of an ability to fully cut the nail and extract it in two pieces by using a Jumbo cutter which is available in the orthopaedic armamentarium. This technique is simple yet economical, with the likelihood of causing less soft tissue damage and thermal necrosis.
ABSTRACT
El presente documento contiene la cartilla de instalación, uso y mantenimiento del Sistema de Cosecha de Agua Lluvia como una herramienta de aprendizaje para las comunidades de El Salvador. La iniciativa consiste en motivar el involucramiento de las mujeres y los gobiernos locales de los territorios para la implementación de sistemas para la recolección y almacenamiento de agua lluvia, la cual después de ser sometida a un proceso de filtrado casero puede ser usada para consumo humano. La capacidad de almacenamiento de cada sistema es de 25,000 litros de agua, lo que representa una mayor capacidad de almacenamiento frente a otros sistemas similares y es una alternativa de bajo costo para las familias y las comunidades en condiciones de pobreza. Se ha implementado la cosecha de aguas lluvias como una alternativa de bajo costo para comunidades con difícil acceso al agua en el Valle del Jiboa y la Región de Los Nonualcos. A partir de esta iniciativa se busca promover la réplica de los sistemas de cosecha de agua lluvia en otros territorios de El Salvador y avanzar en el empoderamiento de la mujer como agente de cambio dentro de sus familias, comunidades y en el territorio.
This document contains the installation, use and maintenance booklet of the Rainwater Harvesting System as a learning tool for the communities of El Salvador. The initiative consists of motivating the involvement of women and local governments of the territories for the implementation of systems for the collection and storage of rainwater, which after being subjected to a home filtration process can be used for human consumption. The storage capacity of each system is 25,000 liters of water, which represents a greater storage capacity compared to other similar systems and is a low-cost alternative for families and communities in conditions of poverty. Rainwater harvesting has been implemented as a low-cost alternative for communities with difficult access to water in the Jiboa Valley and the Los Nonualcos Region. This initiative seeks to promote the replication of rainwater harvesting systems in other territories of El Salvador and advance the empowerment of women as agents of change within their families, communities and in the territory.
Subject(s)
Women , Rainwater , Water Storage , Low Cost Technology , Rain , Water Supply , Water , El SalvadorABSTRACT
Introducción: la hipertensión arterial es una de las enfermedades crónicas más prevalentes en la población adulta. Su tratamiento incluye medidas higienicodietéticas y fármacos. La adherencia al tratamiento farmacológico es esencial para lograr el objetivo del control de la hipertensión arterial y minimizar las secuelas a largo plazo. Objetivos: determinar la adherencia al tratamiento antihipertensivo y factores asociados al cumplimiento terapéutico Metodología: estudio observacional, descriptivo, prospectivo realizado en pacientes que acudieron a consultorio de Clínica Médica en la Clínica Periférica Campo Vía del Instituto de Previsión Social, en la ciudad de Capiatá, en julio del 2014. Se utilizó el test de Morisky-Green-Levine y una encuesta. Resultados: sólo 39,7% se catalogaron como cumplidores. Estos se caracterizaron por menor tiempo de evolución de la hipertensión arterial, mayor grado de conocimiento sobre la enfermedad, nivel de instrucción superior al primario, menor número de comorbilidades y menor consumo de otros medicamentos. Conclusión: la adherencia al tratamiento antihipertensivo fue 39,7%.
Introduction: Arterial hypertension is one of the most prevalent chronic diseases in the adult population. Its treatment includes hygienic-dietary measures and drugs. Pharmacological treatment adherence is essential to achieve the control of arterial hypertension and minimize long-term consequences. Objective: To determine antihypertensive treatment adherence and factors associated to therapeutic compliance. Methodology: This was a prospective descriptive observational study carried out in patients attending the consultation room of Medical Clinics of the Campo Vía Peripheral Clinic of the Social Security Institute in the city of Capiatá in July, 2014. The Morisky-Green-Levine and a survey were used. Results: Only 39.7% were considered as compliers. They were characterized by having shorter evolution time of arterial hypertension, higher degree of knowledge about the disease, instruction level higher than primary, lower number of comorbidities and lower consumption of other drugs. Conclusion: Antihypertensive treatment adherence was 39.7%.
ABSTRACT
Pulmonary tuberculosis is a major cause of morbidity and mortality World Wide, resulting in the greatest number of deaths due to any other single infectious agent. Drug resistance threatens global tuberculosis control efforts. Multi drug resistance means drug resistance to at least rifampicin and isoniazid. One hundred and nineteen sputum and culture positive patients underwent drug susceptibility to the first line drugs [Isoniazid, Rifampicin, Streptomycin and Ethambutol]. 79/119 patients in addition underwent drug susceptibility to Pyrizinamide, Ofloxacin, Amikacin and Levofloxacin. The susceptibility test shows that 35/119 patients [29.4%] were sensitive to all the tested drugs. 84/119 of the included patients [70.6%] showed drug resistance to at least one of the first line drugs by different patterns. 29/119 patients were diagnosed as MDR cases with a percent of 31% [resistant to both INH and Rifampcin]. This study shows increase incidence of resistance to first line drugs as well as increase incidence of MDR
Subject(s)
Humans , Male , Female , Tuberculosis, Multidrug-Resistant/microbiology , Drug Resistance, Multiple, Bacterial/genetics , Incidence , Sputum/microbiology , Treatment OutcomeABSTRACT
La pandemia de influenza por el virus H1N1 afectó a la población del Paraguay a partir de la primera semana de julio de 2009. La misma se acompañó de un brote inusitado de neumonía de la comunidad. Describe las características demográficas y clínicas de un brote de neumonía de la comunidad durante la pandemia. Se realizó un estudio observacional descriptivo, prospectivo, que incluyó a sujetos adultos portadores de clínicos de enfermedad tipo influenza acompañada de neumonía aguda de la comunidad, internados en el Departamento de Medicina Interna del Hospital Nacional (Itauguá) durante los meses de julio y agosto de 2009. .Este brote determinó gran morbilidad pero baja mortalidad...
Subject(s)
Adult , Pneumonia/complications , Lung Diseases , Lung Diseases/complications , Lung Diseases/diagnosis , Lung Diseases/epidemiology , Lung Diseases/therapy , Paraguay/epidemiologyABSTRACT
El feocromocitoma es un tumor secretor de catecolaminas a partir del cual aparecen las clásicas manifestaciones cardiovasculares. Dentro de los efectos ocasionados por este exceso de catecolaminas circulantes, aparte de la hipertensión arterial, se citan miocarditis y cardiopatía hipertrófica, pero la asociación de cardiopatía hipertrófica asimétrica (CMHA) y feocromocitoma es raray poco conocida, de ahí el interés de presentar el siguiente caso
Subject(s)
Catecholamines , Cardiovascular Diseases , Pheochromocytoma , NeoplasmsABSTRACT
Acute appendicitis caused by combined infection of Enterobius vermicularis and cryptosporidium protozoa in a normally looking appendix described. The patient is a 9-years-old immunocompetent boy who was admitted with acute abdomen and vomiting of one day duration. We believe that this is the first case in the literature that described such a combination. We report this case to increase the awareness of the physicians as well as the pathologists in diagnosing of cryptosporidiosis
Subject(s)
Humans , Male , Enterobius/pathogenicity , Enterobiasis/diagnosis , Cryptosporidium/pathogenicity , Cryptosporidiosis/diagnosis , Appendix/microbiologySubject(s)
Drinking Water , El Salvador , Sanitation , Water , Water Quality , Water Supply , Environment , Public HealthABSTRACT
A study of the hemostatic status of twenty- five patients with cyanotic congenital heart disease, [Group I] twenty patients with congenital acyanotic heart disease [Group II] was undertaken to define the coagulation abnormalities in the cardiac patients when compared to fifteen control children [Group III] of similar age and sex. A significant prolonged bleeding time, prothrombin time, thrombin time was proved in the cyanotic congenital heart group when compared to the control group, Thrombocytopenia, a significant decrease in platelet aggregation with ADP and also a significant decrease in plasma fibrinogen and fibrin degradation product [F.D.P] as shown in Group I, Plasma Anti-thrombin- III [ATIII], plasma total and free protein S levels, protein C levels showed a non significant change in congenital cyanotic heart. The only abnormality in acyanotic patient was a slightly prolonged bleeding time and prothrombin time not statistically significant. Because of the abnormal hemostasis in congenital cyanotic heart disease, each child must be studied and considered separately prior to surgery
Subject(s)
Humans , HemostasisABSTRACT
A study of the coagulation system of twenty full term, fifteen premature were compared to twenty normal adults receiving no medication. The fibrinogen level is proved to be normal in fullterm [274 +/- 61 mg/dl] and preterm infants [268 +/- 64 mg/ dl] when compared to the adult group [283 +/- 58 mg/dl]. Prothrombin and protein C are vitamin-K dependent proteins with important roles in haemostasis. The work showed that levels of both proteins are significantly lower than the adult and related to gestational age. Protein C level in the full term [45.6 +/- 10.2], premature [35.5 +/- 6.8] was lower than the adult [95.6 +/- 8.4] also the prothrombin level in the full term [60.4 +/- 12.9], premature [41.3 +/- 5.4] was low when compared to the adult [98.9 +/- 4.1]. A deficiency of antithrombin 111 in the newborn [59.5 +/- 14.3], preterm [41.2 +/- 12.2] is shown by comparison to the adult [89.7 +/- 10.1], the level of antithrombin III in the neonate is commensurate with the level of the vitamin K factors that it inhibits. So normally there is a delicate balance between procoagulants and inhibitors of clotting mechanism in infants. The normal ranges of the levels of prothrombin, protein C, Anti 111, total and free protein S have to be studied in later infancy and the age at which adult levels are reached need to be established
Subject(s)
NeonatologyABSTRACT
Serum prolactin was measured by R I A. in mixed cord of 18 infants of diabetic mothers [I D.M], 18 infants of pergnancy induced hypertension compared to 20 normal full term newborns. The cord prolactin level of infants of women with pregnancy induced hypertension was higher 345 +/- 34.2 ng/ml when compared to cord blood of full term infants 280 +/- 20.4 ng/ml. Infants of diabetic mothers had significantly lower mixed cord serum prolactin levels than control infants 220 +/- 15 ng/ml versus 280 +/- 20.4 ng/ml [less than 0.001]. Fetal Apgar score was lower in I D.M. than controls more significant at one minute than 5 minutes. One infant from the 18 infants of diabetic mothers was reported to develop respiratory distress syndrome [R D.S] with serum prolactin 150 ng/ml, estradiol 5.9 ng/ml, cortisol 68 ng/ml. Serum prolactin considered one of the several hormones responsible for fetal lung maturation was found to be lower in I D.M. than control. These findings raise the possibility than decreased fetal prolactin levels may be associated with or contribute to, the delayed lung maturation reported with diabetic pregnancies