Modified Graham patch repair for cecal perforation: A case report.

INTRODUCTION AND IMPORTANCE: Acute appendicitis is a common cause of acute abdomen worldwide. The complications associated with it can sometimes be unpredictable and pose a dilemma in the management of such complications. CASE PRESENTATION: A case of 18 year female with complaints of right iliac fossa pain and vomiting was diagnosed clinically as acute appendicitis and underwent emergency open appendectomy where a cecal perforation was encountered intra-operatively for which a Modified Graham's Patch Repair was done. CLINICAL DISCUSSION: Acute appendicitis can sometimes present with complications like perforation, among which cecal perforation is rare and difficult to diagnose in the initial setting. Perforated appendicitis or colon can increase morbidity and mortality significantly. High degree of suspicion and early surgical approach can lead to identification of rare complications, which can still pose a surgical dilemma on the approach of management. CONCLUSION: Cecal perforation in suspected acute appendicitis is a rarely encountered intra operative complication. Management approaches can range from less invasive suture with omental patch repair to more invasive right hemicolectomy.

An ischemic complication of a snake bite: Case report.

INTRODUCTION AND IMPORTANCE: Snakebite is a common type of animal bite injury worldwide. The local effect can manifest as an abscess followed by cellulitis and compartment syndrome which could cause ischemic tissue damage. CASE PRESENTATION: A case of a 40-year male with a history of a snake bite 4 days back complained of swelling, throbbing pain, bluish discoloration of the skin and blackish discoloration of the little finger. Incision and drainage were done initially with disarticulation of the gangrenous little finger and finally treated with a split-thickness graft. CLINICAL DISCUSSION: Snakebite can lead to only the bite mark without clinical features, local manifestations around the bite site, systemic toxicity due to redistribution of venom and signs and symptoms due to traditional treatment. Delayed presentation and improper treatment can lead to wound infection, abscess, compartment syndrome, necrotizing fasciitis and gangrene. CONCLUSION: Snakebite is common in rural areas around the tropical world. Complications like compartment syndrome, necrotizing fasciitis and gangrene could develop following snake bite for which immediate surgical intervention is required to prevent loss of limb and life.

Risk perception among residents living near industries in Godawari Municipality of Lalitpur, Nepal.

The industrial sector stands out as a significant contributor to environmental pollution. Those who reside in close proximity to industrial areas commonly harbor concerns about potential health and environmental hazards. This study aimed to find out the perception of risk and self-reported health impacts among individuals living near industries in Godawari Municipality, Lalitpur, Nepal. Conducted as a community-based cross-sectional study, it involved 270 households. Face-to-face interviews were employed, utilizing a pretested structured questionnaire. The study zone encompassed the communities of Godawari Municipality within a 3-kilometer radius of industrial sites. Specifically, stone mines, stone crushers, and brick kilns were purposefully selected, while study participants were randomly sampled using a random table. Data analysis was performed using IBM SPSS, incorporating both univariate and bivariate techniques. Among those residing near industrial zones, a mere 9.6 % reported experiencing wheezing or whistling in the past 12 months. A substantial 36.3% consistently felt stressed due to industrial activities in their vicinity. Approximately half (51.9 %) of the participants indicated that the contaminated air in the area had adverse effects on human health. Furthermore, a palpable perception of elevated risk was associated with the proximity of industries (p<0.001). Over half of the participants perceived a notable risk stemming from the presence of industries near their homes, largely due to pollutants. These individuals also disclosed various health repercussions and expressed significant apprehension regarding their future well-being in the area. The implications of these findings are substantial, particularly for local-level planning and the development of industrial sites. Addressing the concerns surrounding people's heightened perception of risk from nearby industries is pivotal in fostering harmonious coexistence and informed decision-making.

Antibiotic dispensing knowledge and practice among dispensing staff working in pharmacies near teaching hospitals in Kathmandu Valley, Nepal.

OBJECTIVES: To assess antibiotic dispensing knowledge and practice among dispensing staff who may or may not have a formal pharmacy qualification working in pharmacies near teaching hospitals in Kathmandu Valley, Nepal. METHODS: A face-to-face cross-sectional study was conducted among 220 dispensing staff. The data were analysed using SPSS 20 to measure descriptive statistics and logistic regressions. KEY FINDINGS: Among 220 participants, half of them (50.0%) had inadequate knowledge and slightly less than half of the participants (46.4%) had poor antibiotics dispensing practices. CONCLUSIONS: The government authority should develop and implement a plan for continuous professional education programmes and frequent monitoring of pharmacies to address inadequate antibiotic dispensing knowledge and poor practice.

The Healthy, Aging, and Diseased Kidney: Relationship with Cardiovascular Disease.

The cardiovascular and renal systems share an intimate physiological relationship, wherein a perturbance in one system may have an adverse effect on the other. Since the burden of renal disease increases with age, there is a considerable interest in the pathophysiology of kidney disease in the geriatric patient population. This review will explore the physiological dynamics behind the increased susceptibility to kidney disease in this population. A better understanding of these pathophysiological changes may lead to improved prevention and management strategies.