Traditional medicine poisoning in Zimbabwe: clinical presentation and management in adults

2002 ◽  
Vol 21 (11) ◽  
pp. 579-586 ◽  
Author(s):  
D Tagwireyi ◽  
D E Ball ◽  
C F B Nhachi
Keyword(s):  
Traditional Medicine ◽  
Hospital Admissions ◽  
Case Series ◽  
Signs And Symptoms ◽  
Adverse Outcomes ◽  
Therapeutic Modality ◽  
African Countries ◽  
Retrospective Case ◽  
Traditional Medicines ◽  
Referral Hospitals

Traditional medicines (TMs) have been reported as major causes of hospital admissions in some African countries including Zimbabwe. There is, however, still a paucity of information with regards to their clinical presentations. We carried out a retrospective case series of all cases of traditional medicine poisoning (TMP) at eight main referral hospitals in Zimbabwe (January 1998–December 1999 inclusive) to describe the most common signs and symptoms, reasons for, and management of TMP in adults. Where the reasons for taking the TM were known, most cases had taken the medicine for either abdominal pains or aphrodisiac purposes. Nonspecific adverse effects including vomiting, abdominal pains, and diarrhoea were the most commonly encountered. A large proportion of patients with TMP also suffered from genito-urinary tract adverse outcomes especially haematuria and dysuria. Intravenous fluids were the most commonly employed therapeutic modality for TMP, probably in an effort to dilute or increase excretion of the toxins. Further research is required to elucidate the toxic components responsible for the observed ill effects and whether these effects are due to the medicines themselves or to co-existing illnesses.

Can Seizures Be the Sole Manifestation of Meningitis in Febrile Children?

PEDIATRICS ◽  
1993 ◽  
Vol 92 (4) ◽  
pp. 527-534
Author(s):  
Steven M. Green ◽  
Steven G. Rothrock ◽  
Kathleen J. Clem ◽  
Raymond F. Zurcher ◽  
Laura Mellick
Keyword(s):  
Bacterial Meningitis ◽  
Lumbar Puncture ◽  
Decision Rules ◽  
Case Series ◽  
Signs And Symptoms ◽  
Viral Meningitis ◽  
Retrospective Case ◽  
Nuchal Rigidity ◽  
Referral Hospitals ◽  
Meningitis In Children

Objective. It is frequently taught that lumbar puncture is a mandatory procedure in many or all children who have fever and a seizure, because the convulsion may represent the sole manifestation of bacterial meningitis. We attempted to determine the incidence of this occult manifestation of meningitis. Design. Retrospective case series. Setting and patients. 503 consecutive cases of meningitis in children aged 2 months to 15 years seen at two referral hospitals during a 20-year period. Main outcome measures. Signs and symptoms of meningitis in patients having associated seizures. Results. Meningitis was associated with seizures in 115 cases (23%), and 105 of these children were either obtunded or comatose at their first visit with a physician after the seizure. The remaining 10 had relatively normal levels of consciousness and either were believed to have viral meningitis (2) or possessed straightforward indications for lumbar puncture: nuchal rigidity (6), prolonged focal seizure (1), or multiple seizures and a petechial rash (1). No cases of occult bacterial meningitis were found. Conclusion. In our review of 503 consecutive children with meningitis, none were noted to have bacterial meningitis manifesting solely as a simple seizure. We suspect that this previously described entity is either extremely rare or nonexistent. Commonly taught decision rules requiring lumbar puncture in children with fever and a seizure appear to be unnecessarily restrictive.

An Active In-Home Physician Model of Palliative Care and Its Resulting Performance Indicators Related to Home Deaths, Unplanned Emergency Department Visits and Unplanned Hospital Admissions

2020 ◽  
Vol 36 (1) ◽  
pp. 46-49
Author(s):  
Colleen Webber ◽  
Aurelia Ona Valiulis ◽  
Peter Tanuseputro ◽  
Valerie Schulz ◽  
Tavis Apramian ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Hospital Admissions ◽  
Case Series ◽  
Palliative Care Team ◽  
Emergency Department Visits ◽  
Care Team ◽  
Retrospective Case ◽  
Palliative Care Teams ◽  
Unplanned Hospital Admissions

Background: Limited research has characterized team-based models of home palliative care and the outcomes of patients supported by these care teams. Case presentation: A retrospective case series describing care and outcomes of patients managed by the London Home Palliative Care Team between May 1, 2017 and April 1, 2019. Case management: The London Home Palliative Care (LHPC) Team care model is based upon 3 pillars: 1) physician visit availability 2) active patient-centered care with strong physician in-home presence and 3) optimal administrative organization. Case outcomes: In the 18 month study period, 354 patients received care from the London Home Palliative Care Team. Most significantly, 88.4% ( n = 313) died in the community or at a designated palliative care unit after prearranged direct transfer; no comparable provincial data is available. 21.2% ( n = 75) patients visited an emergency department and 24.6% ( n = 87) were admitted to hospital at least once in their final 30 days of life. 280 (79.1%) died in the community. These values are better than comparable provincial estimates of 62.7%, 61.7%, and 24.0%, respectively. Conclusion: The London Home Palliative Care (LHPC) Team model appears to favorably impact community death rate, ER visits and unplanned hospital admissions, as compared to accepted provincial data. Studies to determine if this model is reproducible could support palliative care teams achieving similar results.

Orbital relapse in children treated for Pre-B ALL, a retrospective case series

2020 ◽  
pp. 1-7
Author(s):  
Komal Seher ◽  
Saadiya Javed Khan
Keyword(s):  
Central Nervous System ◽  
Bone Marrow ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Case Series ◽  
Signs And Symptoms ◽  
Ocular Tissue ◽  
Cell Leukaemia ◽  
Retrospective Case ◽  
Ocular Lesions

Abstract About 85-90% of children with B-cell leukaemia are cured. If relapse occurs it is usually in the bone marrow (BM), followed by extramedullary sites. Ocular lesions occur secondary to the accumulation of circulating blasts in the uvea, optic disc, intra-ocular tissue as well as fluid. Here we report four patients with ocular complaints that led to the diagnosis of relapse. Among 475 children with leukaemia treated from January 2013 to December 2018, 50 (10.5%) patients relapsed. Four (8%) out of these 50 presented with orbital symptoms. Central Nervous System (CNS) evaluation by cerebrospinal fluid (CSF) was negative at relapse. Relapse was treated with chemotherapy R3 protocol. Three (75%) patients are alive, while the fourth patient had a second BM relapse and died. Ophthalmic signs and symptoms in patients with treated leukaemia warrant a thorough evaluation. Continuous...  

scholarly journals Super-Selective Mesenteric Embolization Provides Effective Control of Lower GI Bleeding

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Toan Pham ◽  
Bob Anh Tran ◽  
Kevin Ooi ◽  
Marcus Mykytowycz ◽  
Stephen McLaughlin ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Multidetector Ct ◽  
Clinical Success ◽  
Case Series ◽  
Effective Control ◽  
Gi Bleeding ◽  
Retrospective Case ◽  
Bowel Ischaemia ◽  
Radionuclide Scintigraphy ◽  
Lower Gi Bleeding

Introduction. We aimed to assess the efficacy and safety of digital subtraction angiography (DSA) and super-selective mesenteric artery embolization (SMAE) in managing lower GI bleeding (LGIB). Method. A retrospective case series of patients with LGIB treated with SMAE in our health service. Patients with confirmed active LGIB, on either radionuclide scintigraphy (RS) or contrast-enhanced multidetector CT angiography (CE-MDCT), were referred for DSA +/− SMAE. Data collected included patient characteristics, screening modality, bleeding territory, embolization technique, technical and clinical success, short-term to medium-term complications, 30-day mortality, and progression to surgery related to procedural failure or complications. Results. There were fifty-five hospital admissions with acute unstable lower gastrointestinal bleeding which were demonstrable on CE-MDCT or RS over a 31-month period. Eighteen patients proceed to embolization, with immediate success in all. Eight patients (44%) had clinical rebleeding after intervention, warranting repeated imaging. Only one case (5.6%) demonstrated radiological rebleeding and was reembolized. Complication rate was excellent: no bowel ischaemia, ischaemic stricture, progression to surgery, or 30-day mortality. Conclusion. SMAE is a viable, safe, and effective first-line management for localised LGIB. Our results overall compare favourably with the published experiences of other institutions. It is now accepted practice at our institution to manage localised LGIB with embolization.

scholarly journals COVID-19 hospitalizations in five California hospitals: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miriam Nuño ◽  
Yury García ◽  
Ganesh Rajasekar ◽  
Diego Pinheiro ◽  
Alec J. Schmidt
Keyword(s):  
Mortality Rate ◽  
Hospital Admissions ◽  
Large Population ◽  
Case Series ◽  
The United States ◽  
Composite Outcome ◽  
Retrospective Case ◽  
Hospital System ◽  
Icu Admission ◽  
Increased Risk

Abstract Background The novel coronavirus pandemic has had a differential impact on communities of color across the US. The University of California hospital system serves a large population of people who are often underrepresented elsewhere. Data from hospital stays can provide much-needed localized information on risk factors for severe cases and/or death. Methods Patient-level retrospective case series of laboratory-confirmed COVID-19 hospital admissions at five UC hospitals (N = 4730). Odds ratios of ICU admission, death, and a composite of both outcomes were calculated with univariate and multivariate logistic regression based on patient characteristics, including sex, race/ethnicity, and select comorbidities. Associations between comorbidities were quantified and visualized with a correlation network. Results Overall mortality rate was 7.0% (329/4,730). ICU mortality rate was 18.8% (225/1,194). The rate of the composite outcome (ICU admission and/or death) was 27.4% (1298/4730). Comorbidity-controlled odds of a composite outcome were increased for age 75–84 (OR 1.47, 95% CI 1.11–1.93) and 85–59 (OR 1.39, 95% CI 1.04–1.87) compared to 18–34 year-olds, males (OR 1.39, 95% CI 1.21–1.59) vs. females, and patients identifying as Hispanic/Latino (OR 1.35, 95% CI 1.14–1.61) or Asian (OR 1.43, 95% CI 1.23–1.82) compared to White. Patients with 5 or more comorbidities were exceedingly likely to experience a composite outcome (OR 2.74, 95% CI 2.32–3.25). Conclusions Males, older patients, those with multiple pre-existing comorbidities, and those identifying as Hispanic/Latino or Asian experienced an increased risk of ICU admission and/or death. These results are consistent with reported risks among the Hispanic/Latino population elsewhere in the United States, and confirm multiple concerns about heightened risk among the Asian population in California.

scholarly journals Characteristics and risk factors for COVID-19 diagnosis and adverse outcomes in Mexico: an analysis of 89,756 laboratory–confirmed COVID-19 cases

2020 ◽  
Author(s):  
Theodoros V Giannouchos ◽  
Roberto A Sussman ◽  
José Manuel Mier Odriozola ◽  
Konstantinos Poulas ◽  
Konstantinos Farsalinos
Keyword(s):  
Risk Factors ◽  
Adverse Outcome ◽  
Chronic Renal Disease ◽  
Case Series ◽  
Patient Characteristics ◽  
Male Gender ◽  
Adverse Outcomes ◽  
Retrospective Case ◽  
Middle Income ◽  
Clinical Endpoints

AbstractBackgroundThere is insufficient information about risk factors for COVID-19 diagnosis and adverse outcomes from low and middle-income countries (LMICs).ObjectivesWe estimated the association between patients’ characteristics and COVID-19 diagnosis, hospitalization and adverse outcome in Mexico.MethodsThis retrospective case series used a publicly available nation-level dataset released on May 31, 2020 by the Mexican Ministry of Health, with patients classified as suspected cases of viral respiratory disease. Patients with COVID-19 were laboratory-confirmed. Their profile was stratified by COVID-19 diagnosis or not. Differences among COVID-19 patients based on two separate clinical endpoints, hospitalization and adverse outcome, were examined. Multivariate logistic regressions examined the associations between patient characteristics and hospitalization and adverse outcome.ResultsOverall, 236,439 patients were included, with 89,756 (38.0%) being diagnosed with COVID-19. COVID-19 patients were disproportionately older, males and with increased prevalence of one or more comorbidities, particularly diabetes, obesity, and hypertension. Age, male gender, diabetes, obesity and having one or more comorbidities were independently associated with laboratory-confirmed COVID-19. Current smokers were 23% less likely to be diagnosed with COVID-19 compared to non-smokers. Of all COVID-19 patients, 34.8% were hospitalized and 13.0% experienced an adverse outcome. Male gender, older age, having one or more comorbidities, and chronic renal disease, diabetes, obesity, COPD, immunosuppression and hypertension were associated with hospitalization and adverse outcome. Current smoking was not associated with adverse outcome.ConclusionThis largest ever case series of COVID-19 patients identified risk factors for COVID-19 diagnosis, hospitalization and adverse outcome. The findings could provide insight for the priorities the need to be set, especially by LMICs, to tackle the pandemic.

Outcomes Following Balloon Dilation of Benign Urethral Strictures in Dogs: Eight Cases (2005–2018)

2020 ◽  
Vol 56 (1) ◽  
pp. 23-29
Author(s):  
Taylor Estes Gin ◽  
Patty Secoura ◽  
Tonya Harris ◽  
Shelly Vaden
Keyword(s):  
Urinary Incontinence ◽  
Therapeutic Option ◽  
Balloon Dilation ◽  
Clinical Signs ◽  
Case Series ◽  
Invasive Procedure ◽  
Underlying Disease ◽  
Adverse Outcomes ◽  
Retrospective Case ◽  
Urethral Strictures

ABSTRACT Balloon dilation has been described infrequently as a treatment for benign urethral strictures in dogs but is often a first-line therapeutic option for humans. Additional evidence is needed to evaluate the potential role of this procedure in veterinary medicine. The aim of the study was to describe the techniques used and evaluate the response to balloon dilation of benign urethral strictures in dogs. Medical records were reviewed from eight client-owned dogs who underwent balloon dilation of a benign urethral stricture over a 13 yr period in this retrospective case series. Clinical signs improved for five of eight dogs after a single balloon dilation during a follow-up period of 1 wk to 3 yr. After a second procedure, an additional dog demonstrated improvement for 5.5 yr. Adverse outcomes included urinary incontinence in two dogs and recurrent bacteriuria in four dogs. Findings suggest that balloon dilation is an effective, minimally invasive procedure for the treatment of benign urethral strictures in dogs. Urinary incontinence, urinary tract infection, and stricture recurrence are potential outcomes for dogs undergoing this procedure either as a result of the nature of the underlying disease or as a result of the procedure.

scholarly journals Characteristics and risk factors for COVID-19 diagnosis and adverse outcomes in Mexico: an analysis of 89,756 laboratory–confirmed COVID-19 cases

2020 ◽  
pp. 2002144 ◽  
Author(s):  
Theodoros V. Giannouchos ◽  
Roberto A Sussman ◽  
José M Mier ◽  
Konstantinos Poulas ◽  
Konstantinos Farsalinos
Keyword(s):  
Risk Factors ◽  
Adverse Outcome ◽  
Chronic Renal Disease ◽  
Case Series ◽  
Patient Characteristics ◽  
Male Gender ◽  
Adverse Outcomes ◽  
Retrospective Case ◽  
Middle Income ◽  
Clinical Endpoints

BackgroundThere is insufficient information about risk factors for COVID-19 diagnosis and adverse outcomes from low and middle-income countries (LMICs).ObjectivesWe estimated the association between patients’ characteristics and COVID-19 diagnosis, hospitalisation and adverse outcome in Mexico.MethodsThis retrospective case series used a publicly available nation-level dataset released on May 31, 2020 by the Mexican Ministry of Health, with patients classified as suspected cases of viral respiratory disease. Patients with COVID-19 were laboratory-confirmed. Their profile was stratified by COVID-19 diagnosis or not. Differences among COVID-19 patients based on two separate clinical endpoints, hospitalisation and adverse outcome, were examined. Multivariate logistic regressions examined the associations between patient characteristics and hospitalisation and adverse outcome.ResultsOverall, 236 439 patients were included, with 89 756 (38.0%) being diagnosed with COVID-19. COVID-19 patients were disproportionately older, males and with increased prevalence of one or more comorbidities, particularly diabetes, obesity, and hypertension. Age, male gender, diabetes, obesity and having one or more comorbidities were independently associated with laboratory-confirmed COVID-19. Current smokers were 23% less likely to be diagnosed with COVID-19 compared to non-smokers. Of all COVID-19 patients, 34.8% were hospitalised and 13.0% experienced an adverse outcome. Male gender, older age, having one or more comorbidities, and chronic renal disease, diabetes, obesity, COPD, immunosuppression and hypertension were associated with hospitalisation and adverse outcome. Current smoking was not associated with adverse outcome.ConclusionThis largest ever case series of COVID-19 patients identified risk factors for COVID-19 diagnosis, hospitalisation and adverse outcome. The findings could provide insight for the priorities the need to be set, especially by LMICs, to tackle the pandemic.

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