Awareness of risk factors and warning signs of stroke among caregivers of patient with and not with stroke: Results from questionnaire.

OBJECTIVE: To assess the awareness/knowledge of stroke risk factors and warning signs among caregivers of patients with or without stroke. METHODS: The cross-sectional, descriptive and comparative study was conducted in the neurology clinic and polyclinic of a university hospital in Izmir, Turkey, from March to July 2014, and comprised primary caregivers of patients with stroke in group 1 and those of patients with no stroke in group 2. The subjects were screened and data was collected using the Participant Information Form and the Questionnaire Form About Stroke. Warning signs and symptoms of stroke were compared between the two sets of caregivers. SPSS 17was used for data analysis. RESULTS: Of the 203 respondents, 105(52%) were in group 1 and 98(48%) in group 2. Group 1 had better awareness than group 2 (p<0.05). In group 1, weakness was the most commonly recognised warning sign 101(96.2%), whereas dyspnoea 41(39%), was the least commonly identified. There was no relationship of stroke knowledge with educational level and age (p>0.05 each). . CONCLUSIONS: Caregivers had a moderate knowledge of some of the warning signs and risk factors about stroke.

Evaluation of the clinical efficacy of subconjunctival injection of clindamycin in the treatment of naturally occurring infectious bovine keratoconjunctivitis.

OBJECTIVE: To determine the clinical efficacy of subconjunctival injection of clindamycin in the treatment of naturally occurring infectious bovine keratoconjunctivitis (IBK). ANIMALS STUDIED: Clinically, out of 81 animals examined, 46 were found to be suffering from IBK of variable severity. The ocular secretions were collected and cultured for Moraxella bovis. The study included 36 Holstein cattle from which M. Bovis was isolated. These animals ranged between 4 and 28 months of age. PROCEDURES: The severity of the clinical findings were scored as normal, mild, moderate, and severe. Clindamycin was injected subconjunctivally at a total dose of 150 mg (1 mL), once daily for 3 days to the test group (n = 18); isotonic saline solution (1 mL) was administered to the control group. After treatment, all cattle were re-examined and clinical response was evaluated on days 3, 7 and 15 post-treatment. RESULTS: Compared with the control group and prior to treatment, all active lesions such as blepharospasm, epiphora, photophobia, chemosis, corneal edema, and corneal ulceration were generally resolved by day 15 after subconjunctival injection of clindamycin. Severity of IBK lesions increased on days 3 and 7, compared to baseline in the control group administered isotonic saline solution. CONCLUSIONS: The results of this study suggest that subconjunctival injection of clindamycin is effective in the treatment of naturally occurring infectious bovine keratoconjunctivitis.

Fournier gangrene. Approaches to diagnosis and treatment.

OBJECTIVE: To investigate the factors associated with patients with Fournier's gangrene, and to clarify the effect of diabetes mellitus (DM) as a comorbid disease on morbidity and mortality of patients with Fournier's gangrene. METHODS: Twenty-six Fournier's gangrene patients who were admitted to the Emergency Department of Ankara Numune Teaching and Research Hospital, Ankara, Turkey from 1997 to 2003 were examined retrospectively. RESULTS: The mean age of the patients was 52.8 years. There were 8 female (30.8%) and 18 male (69.2%) patients. The etiological causes were as follows: diseases of the perianal region, history of operations, trauma and injections. Major comorbid disease states were diabetes mellitus (DM) and hypertension. The lesions in Fournier's gangrene were most commonly located in the perineum and genital region. Female patients with diabetes mellitus had significantly unusual extensive involvement, especially abdominal wall involvement. The most frequently isolated pathogen was Escherichia coli, while staphylococcal infection was most commonly seen in the presence of DM. Colostomy was performed on 53.8% of the patients, and cystostomy on 7.6% of the patients. Average time of staying at the hospital was 25 days with a mortality rate of 34.6%. Patients with DM had high mortality rates and stayed longer at the hospital than the non-diabetic patients. CONCLUSION: In addition to early diagnosis, early and aggressive debridement and administration of multiple wide spectrum antibiotics chosen for the causative agent are the golden standard for decreasing the mortality and morbidity. Diabetes mellitus has been found to be an important factor to increase mortality rates of patients with Fournier's gangrene.