RESUMEN
Necrotizing fasciitis is an uncommon disease that results in gross morbidity and mortality if not diagnosed and treated in its early stages. At onset, however, it is difficult to differentiate from other superficial skin conditions such as cellulitis. Family physicians must have a high level of suspicion and low threshold for surgical referral when confronted with cases of pain, fever, and erythema. We present ten cases of necrotizing fasciitis managed in a provincial secondary hospital in Oman over 3 years ago. A review of recent literature is also presented.
Asunto(s)
Fascitis Necrotizante/diagnóstico , Anciano , Fascitis Necrotizante/cirugía , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Head and neck cancer constitutes one of the commonest malignancies in Yemen. There may be a role for the use of Shamma and Zarda and Khat for the increase of HNC in Yemen. This study was conducted retrospectively with an overall aim to describe the pattern of head and neck cancers among Yemeni patients attending the Oncology Department of Al-Gamhouria Teaching Hospital, Aden, for the period from Jan. 2001 to Dec. 2004. The study included 183 patients with head and neck cancers (Lymphoma and thyroid were excluded), 134 were males (73.2%) and 49 were females (26.8%) , with male to female ratio of 2.7:1. The mean age was 51.3 +/- 14.9 years (range: 3 - 82 years). Statistically, there is significant difference between the mean age of male (49.5 +/- 15.1 years) and female (45.4 +/- 16.3 years) patients with head and neck cancers [t= 2.1, p: 0.03]. The common types of head and neck cancers in this study are cancers of the oral cavity (31.7%), followed by pharyngeal (22.9%) and laryngeal (19.1%). In relation to sex, there is a significant statistical relationship between certain head and neck cancers and sex (p: 0.0000). In males, the common cancers are oral cavity cancers (22.7%), laryngeal (22.1%) and pharyngeal cancers (20.8%). The common histopathological type of head and neck cancers in this study is the well differentiated squamous cell carcinoma (70.5%). This study concluded that head and neck cancers are among the common health problems affecting Yemeni patients and recommended further wide national studies to determine the real incidence and the risk factors associated with such cancer.
Asunto(s)
Carcinoma de Células Escamosas/epidemiología , Neoplasias de Cabeza y Cuello/epidemiología , Adolescente , Adulto , Anciano , Carcinoma de Células Escamosas/patología , Niño , Preescolar , Femenino , Neoplasias de Cabeza y Cuello/patología , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Yemen/epidemiología , Adulto JovenRESUMEN
A 1-year study of the etiology of acute diarrhea complicated by severe (10%) dehydration, active bleeding, shock and cardiovascular collapse, pneumonia, acute renal failure, or seizures in infants under 18 months of age was performed in Cairo, Egypt. Of 145 infants, 19 (13%) died or left the hospital moribund; the remaining 126 patients were classified as having potentially fatal illness. A variety of enteropathogens were identified with approximately equal frequency in the fatal and nonfatal complicated cases as well as in 135 controls with severe uncomplicated diarrhea. The agents most frequently detected in infants with severe diarrhea in this population which were felt to be etiologically important were rotavirus (33%), heat-stable enterotoxin-producing Escherichia coli (20%), heat-labile enterotoxin-producing E. coli (11%), enteropathogenic E. coli (8%), and Salmonella spp. (5%). The high rate of occurrence of Giardia lamblia (35%) probably represented the high carriage rate of the protozoan in this population. Complicated (fatal and potentially fatal) cases differed from control cases in a number of ways: the onset of diarrhea was more sudden, the course was progressive and of greater initial intensity, vomiting occurred more frequently, the patients more often had visited another physician before coming to the hospital, the patients more often had respiratory symptoms and pulmonary abnormalities on auscultation, hypoactive bowel sounds and abdominal distention were more common, as was oliguria, and the patients showed lower mean body weights.
Asunto(s)
Diarrea/microbiología , Infecciones por Escherichia coli/epidemiología , Giardiasis/epidemiología , Infecciones por Rotavirus/epidemiología , Infecciones por Salmonella/epidemiología , Diarrea/mortalidad , Diarrea/parasitología , Egipto , Escherichia coli/aislamiento & purificación , Femenino , Giardia/aislamiento & purificación , Humanos , Lactante , Masculino , Rotavirus/aislamiento & purificación , Salmonella/aislamiento & purificaciónRESUMEN
PIP: A major criticism of the use of oral rehydration solution (ORS) in the treatment of diarrhea has been that the high sodium content of the solution might predispose the development of hypernatremia in infants not allowed access to additional free water and in whom glomerular filtration rate and urinary concentrating ability may be low. A study was undertaken in 1980 in Cairo, Egypt to assess the use of ORS. The study included 100 children under age 1, mean age 6.7 months, with dehydration secondary to diarrhea, and 17% were hypernatremic on admission, 27% hyponatremic and 56% isonatremic; the hypernatremic infants were found to be more dehydrated than the others. 24% of the hypernatremic infants had taken Rehydran whereas only 5% of the others had taken it and none had been given the medication in a proper fashion. Of the 17 with hypernatremia 16 completed the course of oral rehydration therapy and 63% had normal serum sodium values by 6 hours of therapy. It was found that the treatment of hypernatremic infants with ORS was successful while with the unsupervised use of Rehydran the risk of this condition was enhanced; errors made in the home included prolonged use of the solution and failure to use water. It is believed that because of widespread illiteracy sole reliance upon written instructions is potentially dangerous.^ieng