ABSTRACT
Introduction: Emphysematous pyelonephritis (EPN) is thenecrotizing infection of renal parenchyma with the presence ofgas in the renal parenchyma, collecting system or perinephrictissue. EPN is an uncommon life-threatening conditionprecipitated mainly by poorly controlled blood sugars andurinary tract obstruction. Current research aimed to study theclinical and biochemical factors determining the prognosis ofpatients with acute pyelonephritis.Material and Methods: The study was conducted from June2016 to June 2017 in Tirunelveli Medical college among 50patients of pyelonephritis with classical clinical features. Allbasic blood investigations were done and radiological imaginglike USG, KUB and CT abdomen was done for more detailingand followed up.Results: Females above 50 years of age were more frequentlyaffected by pyelonephritis. Altered sensorium, hypotension,HbA1c values > .5 and thrombocytopenia were noticed ina significant number of cases. Prognosis of cases with thesecomorbid conditions was found to be low. 6 patients died inthis study due to poor glycaemic control, thrombocytopeniaand renal dysfunction.Conclusion: Long-standing and uncontrolled type II diabetesmellitus, hypotension, renal dysfunction, thrombocytopeniaand radiological features of the high-risk disease are allassociated with a poor prognosis.
ABSTRACT
Children aged 6-15 years old experience more injuries to their teeth and the injuries sustained are more serious as evidenced by a higher percentage of luxations, avulsions, fractures and dislocations. The mandible is the most frequently fractured facial bone and mandibular alveolar injuries have been reported to range between 8.1-50.6%. Those with mandibular or midface fractures have a higher incidence of associated chest, extremity, abdomen and cervical spine injuries. The growing patient with facial injuries presents the clinician with a series of thought-provoking circumstances. Dentoalveolar and mandibular injuries are especially important to understand because of the potential complications related to tooth eruption, alveolar development, occlusion and facial growth. However, the principles involved in the treatment for children need to be modified by certain anatomical, physiological and psychological factors specifically related to childhood. This case report documents the trauma, management and follow-up care of an 11-year-old boy who sustained undisplaced infraorbital, nasal fractures and mandibular dentoalveolar fracture along with other associated injuries of the extremities.