Impact of conservative management on the outcome of patients with traumatic renal injury at a tertiary trauma center

OBJECTIVE@#To report the outcomes of patients with traumatic renal injury who were managedconservatively in a tertiary trauma center from date of admission to discharge@*PATIENTS AND METHODS@#The study is a comprehensive chart review on patients diagnosed with traumaticrenal injury, managed conservatively between January 2013- August 2018. Demographic dataincluding age and gender were recorded.@*RESULTS@#A total of 92 patients with renal injury were managed in East Avenue Medical Center fromJanuary 2013 to August 2018. Only 25 of them were managed conservatively and were included inthis study. The patients included in this study had Grade II to V renal injuries and were sent homestable and improved.@*CONCLUSION@#Renal injury may be a life-threatening event in a setting of acute trauma. But if handledappropriately, it can be managed safely without the need for surgical intervention.

A retrospective analysis of Fournier's gangrene at a tertiary government hospital in the Philippines

BACKGROUND@#Fournier's gangrene is a serious illness which involves the external genitalia and perineum.It is rare but a life-threatening form of necrotizing fasciitis. Despite aggressive treatment, the mortalityrate is still high. In this study, the authors will discuss the risk factors and mortality of the saiddisease.@*METHODS@#This is a descriptive retrospective study of patients with Fournier's gangrene treated at atertiary government hospital in the Philippines between January 2014 to December 2016.@*RESULTS@#The data from a total of 16 patients (M:F = 15:1) were analyzed. The most number of patientswere in the 5th decade of life (range 17-75 years). The most commonly-associated morbidity wasdiabetes mellitus (50%). Bacterial culture results were obtained in only 15 (93.7%) patients. Of these,13 (86.6%) had polymicrobial bacterial growth while 2 (13.3%) had monomicrobial bacterial growth.Escherichia coli (93.3%) was the most frequent bacterial organism isolated. All the microorganismsisolated showed high resistance to commonly-used antibiotics except for Meropenem, Piperacillin-Tazobactam, and Ceftriaxone. All patients were treated with broad-spectrum antibiotics, and emergentsurgical debridement. The median length of hospital stay (LOS) was 14.3 days and mortality rate was6.25 %.@*CONCLUSION@#Fournier's gangrene is still a grave disease that can be treated by determining the cause ofinfection and prompt surgical treatment is needed to improve patient outcome.

An in-vitro study in the determination of the permeability of foley catheter to ciprofloxacin

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To examine the ability of an antimicrobial agent Ciprofloxacin to diffuse through a Foley catheter retention balloon.<br /><strong>METHODS:</strong> The Utraviolet-Visible (UV-Vis) Spectophotometer (UV-1700 PharmaSpec) was utilized to detect the diffusion of the analyte (Ciprofloxacin) through end parameters such as peak absorbance and corresponding wavelengths.<br /><strong>RESULTS:</strong> On UV-Vis spectophotometer, the control sample of sterile water was analyzed and found to have the lowest peak absorbance value of only 0.003 at a wavelength of 343 nm. The peak absorbance values of subsequent samples, taken from the same environment (sterile water), since submersion of the catheter balloon, on day-3, day-8, day-15 had increasing peak absorbance values on their corresponding wavelengths.<br /><strong>CONCLUSIONS:</strong> In this study, the samples of sterile water from the outside environment of the submerged catheter yielded progressively increasing peak absorbance values on the succeeding days of submersion. Thereby, In lieu of this principle, one can infr the diffusion of the analyte throgh the catheter membrane, as reflected by the summary of peak absorbance value.</p>

Hematuria meter application as a diagnostic tool in the assessment of the degree of hematuria among post-TURP and post- TURBT patients

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> Hematuria is a common complication of transurethral electrosurgical procedures in the postoperative period. Presently, there is no standard diagnostic tool that will determine the degree of hematuria among postoperative catheterized patients. An innovative way of assessing the degree of hematuria is through the use of Hematuria Meter Application, a mobile device software program.<br /><strong>OBJECTIVE:</strong> The objective of this study was to determine the reliability of the Hematuria Meter Application as a diagnostic tool to assess the degree of hematuria in post-TURP and post-TURBT patients. This study aimed to determine if there is agreement between the Hematuria Meter Application readings and the RBCs counter per high power field by Direct Manual Quantitative Microscopy method and to determine if there is inter-observer agreement in using the Hematuria Meter Application between the patient or relative, nurse, intern and resident urologist.<br /><strong>METHODS:</strong> Using the Hematuria Meter Application, the color of the urine was graded by the patient or relative, resident, intern and nurse. Urine was then collected and sent to the laboratory for quantitative manual RBC counting under the microscope. Intraclass correlation coefficient (ICC) was used to determine teh agreement of the applicatin readings with RBC/hpf and inter-observer agreement among the observers.<br /><strong>RESULTS:</strong> From July 2014 to December 2015, a total of 159 eligible patients were included in this study. The average age was 69. Majority were males (91%). 118 patients out of 159 (74%) underwent TURP, while 41 patients (26%) underwent TURBT. The median age of patients who underwent TURP was 68 while the median age was 66 for patients who underwent TURBT.<br />The agreements of the Hematuria Meter Application readings with RBCs/hpf counted with Direct Manual Quantitative Microscopy method were almost perfect. ICC was 0.743 (p-value 0.000) in day 0 post-operative and 0.985 (p-value 0.000) in day 2 post-operative. Similarly, inter observer agreement was almost perfect and increasing at each period of assessment. In the immediate post-operative period, ICC was 0.832 (p-value 0.000). On second post operative day, ICC was 0.999 (p-value 0.000).<br /><strong>CONCLUSION:</strong> The Hematuria Meter Application is a reliable diagnostic tool in assessing the degree of hematuria in post-TURP and post-TURBT patients. There is inter-observer agreement in using this application.</p>