Iatrogenic sciatic nerve injury : a case report

Sciatic nerve injury is an uncommon presentation seen in primary care. Detailed history and careful physical examination may sometimes be able to elicit this diagnosis and possible cause. Sometimes additional imaging modality such as ultrasound or magnetic resonance imaging may be needed to confirm the diagnosis. This case report will look at a case of 60 years old woman who presented with severe pain and limping over her right lower limb which eventually linked to intramuscular injection given two days earlier for severe knee pain.peer-reviewe

Post-injection Sciatic Neuropathy: A five-year review of cases managed in a paediatric hospital in Ibadan, Nigeria

The World Health Organization (WHO) reported that the administration of injections is one of the most common healthcare procedures, and unsafe injections are associated with morbidity and mortality, especially in developing countries. Post-injection sciatic neuropathy (PISN) has been identified as a serious complication of gluteal intramuscular (IM) injections. The long-term care of PISN poses an economic burden on carers and increases physiotherapists’ burden of care. This study reviewed two hundred and ten cases of PISN among eight hundred paediatric cases seen from January 2004 to December 2008 in the Physiotherapy Clinic of Oni Memorial Children’s Hospital in Ibadan, Nigeria. Each patient was evaluated for the limb affected, the health care centre where the injection was given and the health care personnel who gave the injection. One hundred and twenty three (58.6%) of the patients were male while eighty seven (41.4%) were female. A majority of the injections were administered at private hospitals – 143 (68.1%). The others were at general hospitals 22 (11.2%), by ‘nurses’ at dispensing shops 17 (8.1%) , at primary healthcare centres 12 (5.7%) , and two (1%) were given at home by the children’s grandmothers. Since PISN is a preventable condition, there is a need to minimize gluteal IM injections especially when other routes such as the vastus lateralis muscle can be used. A majority of the children with PISN (84.7%) were below the age of five and this makes it imperative for caution to be exercised when gluteal IM injections are given to this age group. Update and refresher courses should be regularly organized for the health professionals concerned, to minimize the occurrence of PISN. KEY WORDS: post-injection, sciatic neuropathy, paediatric, intramuscula

The risks associated with percutaneous native kidney biopsies: a prospective study

BACKGROUND: The known risks and benefits of native kidney biopsies are mainly based on the findings of retrospective studies. The aim of this multicentre prospective study was to evaluate the safety of percutaneous renal biopsies and quantify biopsy-related complication rates in Italy. METHODS: The study examined the results of native kidney biopsies performed in 54 Italian nephrology centres between 2012 and 2020. The primary outcome was the rate of major complications 1 day after the procedure, or for longer if it was necessary to evaluate the evolution of a complication. Centre and patient risk predictors were analysed using multivariate logistic regression. RESULTS: Analysis of 5304 biopsies of patients with a median age of 53.2 years revealed 400 major complication events in 273 patients (5.1%): the most frequent was a ≥2 g/dL decrease in haemoglobin levels (2.2%), followed by macrohaematuria (1.2%), blood transfusion (1.1%), gross haematoma (0.9%), artero-venous fistula (0.7%), invasive intervention (0.5%), pain (0.5%), symptomatic hypotension (0.3%), a rapid increase in serum creatinine levels (0.1%) and death (0.02%). The risk factors for major complications were higher plasma creatinine levels [odds ratio (OR) 1.12 for each mg/dL increase, 95% confidence interval (95% CI) 1.08-1.17], liver disease (OR 2.27, 95% CI 1.21-4.25) and a higher number of needle passes (OR for each pass 1.22, 95% CI 1.07-1.39), whereas higher proteinuria levels (OR for each g/day increase 0.95, 95% CI 0.92-0.99) were protective. CONCLUSIONS: This is the first multicentre prospective study showing that percutaneous native kidney biopsies are associated with a 5% risk of a major post-biopsy complication. Predictors of increased risk include higher plasma creatinine levels, liver disease and a higher number of needle passes

The morphological variability of the pelvic girdle muscles: a potential trap during ultrasound

Background: The muscles present in the pelvic girdle compartment demonstrate clinically significant anatomical variation regarding both their site of attachment and additions, such as accessory heads, muscles, or tendinous slips. Many of those variations might be considered potential traps during ultrasound examination, which may result in misdiagnosis. The aim of this study was to raise awareness of such a possibility. Materials and methods: A comprehensive search for morphological variations was performed in PubMed and NIH. Relevant papers were listed, and citation tracking was accomplished. Results: Although several anatomical variations of pelvic girdle muscles have been presented, few studies have examined their relevance in ultrasound imaging. Conclusions: The morphological variability of the pelvic girdle muscles does not vary from such incidence in other regions of the human body; however, further ultrasound studies are needed of the numerous morphological variants that can be found in this region

Breast Cancer and Breast Reconstruction

This book has been contrived to gather recent data on a common health problem. As breast cancer imposes a heavy burden for society due to its psychological, social and economic consequences, every step to broaden our understanding is a worthy task. The aim of this book is to provide some insights on this subject through the information given on new perspectives in genetics and diagnosis, exposed in the section on oncologic issues, as well as on recent topics on surgical treatment, presented in the sections on breast conservative and breast reconstructive surgery

Clinical study of Sterile Collagen Particles (BIOFIL) in the management of Chronic Non Healing Ulcer

INTRODUCTION: Patients who are suffering from non healing ulcers may lead into a significant problems and prolonged stress. Pain and discomfort are the main complaint of chronic non healing ulcer patients. Pain may be mild or severe, pricking or burning which may exacerbate with frequent changing of dressings. Wound contracture and scar formation is the end result of any wound healing ulcers. Collagen plays a very important role in the stage of wound healing process. Collagen particles are used in chronic non healing ulcer management. To evaluate their efficacy when compared with conventional method dressings this study which was conducted by our department. OBJECTIVES: To compare the efficacy of healing process in chronic non healing ulcer patients using collagen particles with those of conventional method dressings (betadine dressings). MATERIALS &METHODS: This study was a non - randomized, a prospective type of study evaluated between September, 2014 to August, 2016 in Thanjavur Medical College and Hospital, Thanjavur, Tamilnadu, India. This is the comparative study between collagen particles dressing study group and conventional method dressing control group. Around a total of 104 patients with chronic non healing ulcers in various region and various types were taken in this study. Study group consisting of 52 patients and control group have 52 patients. STUDY RESULTS: The study shows which was a significant increase in the wound healing rate percentage being 92.3% in the study group when compared to the control group percentage being 42.3%. CONCLUSION: Collagen particles dressings found to be effective in the management of chronic non healing ulcer patients compared to the conventional method of betadine dressing. Collagen particles plays an important role by forming an early granulation tissue and scar formation and reduces the duration of the hospital stay

The Ilioinguinal Approach versus the Anterior Intrapelvic Approach to the Acetabulum: A Review

The ilioinguinal approach (IIA) to the acetabulum has been used as a golden standard for fifty years to treat “anterior†acetabular fractures. Since its introduction by Hirvensalo and Cole, the anterior intrapelvic approach (AIPA) has been adopted by some surgeons, whilst others remain devoted to the IIA. IIA is routinely used in the Republic of Macedonia. The aim of this study is to present a review of literature for two different anterior approaches for the treatment of acetabular fractures used in modern day surgery, focussing on AIPA and its priorities and comparing it to IIA.We performed a search, mainly electronically, and retrospective analysis of existing literature. We have identified and selected two representative and well-systematized papers for IIA, and six for AIPA. We presented the advantages and disadvantages, priorities and weaknesses of both approaches separately, comparing complications, risks and results. Based on the facts presented regarding the advantages of AIPA with a focus on visualization, accessibility and biomechanical justification, the approach should be implemented in our everyday practice and we are comfortable in stating this preference, especially due to the fact that upon comparison of the complication rate there is no significant difference between the two approaches

Evolution of opinions on vascular trauma treatment in Polish medical literature at the turn of 19th century

Postęp w zakresie chirurgii naczyniowej zapoczątkowały dążenia do zamiany tradycyjnego sposobu leczenia urazów naczyń z ich podwiązywania na rekonstrukcję. Początkowo stosowano szew boczny, następnie szew okrężny, a w końcu rekonstrukcję naczynia za pomocą wstawki z żyły własnej pacjenta. Na poszczególnych etapach tego procesu metody te konkurowały ze sobą, miały bowiem licznych zwolenników i przeciwników. W 1900 roku sformułowano opinię, że po okrężnym podwiązaniu arterii lub żył w niektórych przypadkach mogą rozwinąć się groźne zaburzenia odżywiania narządów. Nie jest to więc metoda niezawodna, a rozwój chirurgii powinien prowadzić do opracowania sposobów spełniających zasadę zachowania w organizmie całego systemu krwionośnego. Założeniem niniejszej pracy było przedstawienie zgromadzonego polskojęzycznego piśmiennictwa z przełomu XIX i XX wieku dotyczącego działań operacyjnych na naczyniach krwionośnych. Przytoczono opisy wystąpień na posiedzeniach naukowych towarzystw lekarskich, prace oryginalne i poglądowe polskich autorów oraz odnalezione i wydrukowane w języku polskim streszczenia prac zagranicznych z tego okresu. Początkowo podwiązanie naczynia uważano za najbezpieczniejszy sposób opanowania krwotoku lub leczenia tętniaka pourazowego. Rozpoczęcie terapii od rekonstrukcji nie było powszechnie stosowane. Kolejnym etapem, po zaakceptowaniu rekonstrukcji, było zagadnienie zastosowania wstawki z żyły własnej w przypadku rozległego ubytku. W Polsce orędownikiem rekonstrukcji z użyciem wstawki był Romuald Węgłowski. Należy podkreślić, że tę tematykę na stałe włączono do polskiego piśmiennictwa medycznego przełomu wieku, co sprzyjało - widocznemu w opiniach autorów - stopniowemu odchodzeniu od tradycyjnych metod podwiązywania naczyń w kierunku ich rekonstrukcji. Stanowiło to podstawę współczesnej polskiej angiochirurgii.Progress in the treatment of vascular trauma was initiated by a trend to change traditional ligation of injured vessels to their reconstruction. Initially lateral sutures were used, then circular sutures and at last reconstruction of injured vessels with venous homograft. These methods competed for decades, having many advocates and opponents. In the year 1900 it was stated that circular ligation may have a dangerous impact on organ nutrition. It was concluded that this treatment was not satisfactory and different methods of preservation of the continuous vascular system should be developed. The aim of this study is to present a survey of Polish-language medical literature concerning vascular operative techniques from the turn of 19th century. We have listed presentations from the meetings of medical associations, original and review papers as well as published Polish translations of foreign scientific papers. In the beginning ligation seemed to be the best treatment of haemorrhage or posttraumatic aneurysm. The existing method of reconstruction with venous homograft was not commonly performed. When the idea of reconstruction with a venous graft was commonly accepted the main topic of discussion remained the size of the venous graft. In Poland Romuald Weglowski introduced this method of reconstruction. It should be strongly emphasized that this problem was widely presented in Polish medical literature from the end of 19th century, which formed the origins of modern Polish vascular surgery