RESUMO
Background: Cambodia boasts one of the highest incidences of TB in the world. As such, healthcare providers are experienced with types of extrapulmonary TB such as septic Mycobacterium tuberculosis arthritic infections, not seen in developed countries.Objective: To examine the incidence and distribution of TB arthritis cases at a Cambodian surgical center, explore the problems of diagnosis and current methods of treatment for this disease.Methods: The written charts, operation records, and electronic database of patients with clinically diagnosed extrapulmonary TB, confirmed with a positive biopsy between January 2001 and July 2010 were searched. While medical treatment for the TB was given at other facilities, the operations performed and the result for patients with follow-up was reviewed.Results: Between January 2001 and July 2010, 38 cases of TB arthritis at the CSC in Cambodia were histologically confirmed. Twenty-eight cases affected the lower extremity with the majority affecting the knee and ankle. All 13 patients receiving arthrodesis reported positive surgical outcomes.Discussion/Conclusion: TB arthritis persists as an ongoing problem at CSC with a significant level of incidence. Arthrodesis is a viable and cost effective mean of treating TB arthritis in Cambodia.Keywords: Arthritis, arthrodesis, cambodia, fusion, incidence, tuberculosis
RESUMO
Throwing highly corrosive acid into someone’s face to cause the deliberate destruction of an individual’s appearance is a serious assault. Some victims die as a result of the attack, some are blinded, and all have their facial features marred for life, causing severe social isolation and ostracism, and leading some victims to commit suicide years after the attack. Acid attacks in Cambodia are commonplace occurrences: a personal revenge for a variety of interpersonal disputes and perceived insults. Similar attacks occur in other developing countries, most especially in South and South-East Asia, and the first case occurring in Canada was recently reported in the press. Children’s Surgical Centre (CSC) has seen and treated at least 195 patients with acid burns since 1998, and some of the characteristics of the individual circumstances and the surgical care are discussed.
RESUMO
Background: Noma is an orofacial gangrene that tends to afflict starving and malnourished children. It has a high mortality rate, and even if the child survives, a lifelong deformity of the face occurs. There is a worldwide incidence of Noma in areas of mass poverty and famines, but it is rare in South East Asia. In Cambodia, the Children’s Surgical Centre (CSC) has seen and treated 20 patients with facial deformity secondary to Noma occuring in the 1970s (during the “Pol Pot period”). Objective: A review and case report.