Intravenous drug abusers presenting with pseudoaneurysm and other surgical complications in Pakistan

2020 ◽  
pp. 1-8
Author(s):  
Muhammad Amar Qudeer ◽  
Syed Asghar Naqi ◽  
Muhammad Zeeshan Sarwar ◽  
Hafiza Amina Mujahid
Keyword(s):  
Surgical Complications ◽  
Major Amputation ◽  
Drug Abusers ◽  
Injection Equipment ◽  
Surgical Department ◽  
Popliteal Aneurysm ◽  
Surgical Ward ◽  
Infected Pseudoaneurysm ◽  
Life Threatening ◽  
Intravenous Drug Abusers

Abstract People who inject drugs (PWIDs) reuse injection equipment and other paraphernalia, which is a major source of transmission of human immunodeficiency (HIV) and hepatitis C virus (HCV) infections. PWIDs who use infected injections develop many surgical complications which are life- threatening. The most common complication is infected pseudoaneurysm. To assess complications requiring surgery in drug abusers, a study was conducted in the East Surgical Ward of Mayo Hospital Lahore, Pakistan from Jan 2017 to Jan 2019. A total of 48 PWIDs presented to the surgical department, out of which 39 (81%) were HIV positive, and 31 (64%) were HCV positive. Of the 52% who had pseudoaneurysm, 92% had femoral and popliteal aneurysm and 8% had brachial aneurysm. After ligation and excision of pseudoaneurysm only 8% required major amputation. Mortality rate was 0%. Ligation and excision is a safe option in pseudoaneurysm. Continuous...

scholarly journals Infected Pseudoaneurysm in a Tertiary Centre: A Retrospective Audit

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Sanjay DS ◽  
G Dhayalan ◽  
Abdul Rahman MNA ◽  
Othman F
Keyword(s):  
Multiorgan Failure ◽  
Intravenous Drug ◽  
Hiv Positive ◽  
Drug Abusers ◽  
Complication Rates ◽  
Tertiary Centre ◽  
Retrospective Audit ◽  
Infected Pseudoaneurysm ◽  
Male Patients ◽  
Intravenous Drug Abusers

Introduction: Infected pseudoaneurysms among intravenous drug abusers are a serious clinical condition that carries significant morbidity and mortality. The management of such cases has been controversial on deciding the need of revascularisation following simple ligation and local debridement. In this audit, we present the results of simple ligation and local debridement of our patients with infected pseudoaneurysm. Materials and methods: We conducted a retrospective review from 2013 to 2018 on 15 of our patients who are intravenous drug abusers that underwent simple ligation and local debridement for an infected pseudoaneurysm. Results: All 15 patients underwent simple ligation and local debridement. They were all male patients, and majority of the patients were between group ages of 30-40 years old at 66.7%. The oldest patient was 63 years old. All the patients self-injected the affected site for a minimum duration of 36 months. 73% of the patients had femoral pseudoaneurysm, making it the most common affected site in our audit. The remaining patients had axillary and radial pseudoaneurysm and none of our patients had brachial pseudoaneurysms. Majority of our patients were underlying Hepatitis C at 46.7%, 2 of our patients were HIV positive and only one had Hepatitis B. The remaining 5 patients’ statuses were unknown. In accessing the complications, two patients had re-bleeding after the procedure and were eventually discharged well and were uneventful. One patient required amputation as he developed a gangrenous limb within the same admission after ligation and excision of the infected pseudoaneurysm. There were two deaths due to sepsis with multiorgan failure. 10 patients were discharged well without any complications after surgery. Conclusion: Infected pseudoaneurysms can be safely managed with simple ligation and local debridement without revascularisation as they pose acceptable complication rates.

scholarly journals 187 Improving Awareness of Managing Post-Operative Haemorrhage in Patients Undergoing Thyroid and Parathyroid Surgery: The SCOOP Protocol

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Bhattacharya ◽  
J Jegadeeson ◽  
J Ramsingh ◽  
P Truran
Keyword(s):  
Nursing Staff ◽  
Simulation Training ◽  
Clinical Signs ◽  
Skin Wound ◽  
Junior Doctors ◽  
Parathyroid Surgery ◽  
Surgical Department ◽  
Life Threatening ◽  
Clinical Questions ◽  
Life Threatening Complication

Abstract Introduction Post-operative haemorrhage is a rare but potentially life-threatening complication of thyroid surgery and occurs in 1 in 100 patients. Our aim was to assess current levels of awareness of post-operative haemorrhage in the surgical department and to improve confidence in managing this. Method Questionnaires with a combination of clinical questions were distributed amongst nurses, foundation doctors, senior house officers and registrars in the surgical department. Results There was a clear gap in awareness in all grades. The British Association of Endocrine and Thyroid surgeons (BAETS) have guidance on the management of these patients and in particular the acronym SCOOP (Steristrips removed, Cut subcuticular sutures, Open skin wound, Open strap muscles, Pack wound). 18/24 of participants had not heard of the SCOOP protocol. Most nurses (6/12) all junior doctors (8/8) showed lack of confidence in managing patients with suspected bleeding. Conclusions An informative poster was created for relevant clinical areas as per the BAETS recommendation. These posters outlined the steps in the SCOOP acronymas well as the main clinical signs of haemorrhage. BAETS recommend that all first responders, including nursing staff, junior doctors and the crash team should be aware of the SCOOP protocol. Simulation training sessions are in progress for these members of staff.

Risks of human immunodeficiency and hepatitis B viral infections in intravenous drug abusers

1988 ◽  
Vol 148 (5) ◽  
pp. 263-265 ◽  
Author(s):  
Mary‐Louise McLaws ◽  
Joseph McGirr ◽  
William Croker ◽  
David A. Cooper
Keyword(s):  
Hepatitis B ◽  
Viral Infections ◽  
Intravenous Drug ◽  
Drug Abusers ◽  
Intravenous Drug Abusers

HTLV-III ANTIBODY IN SWISS AND ENGLISH INTRAVENOUS DRUG ABUSERS

The Lancet ◽  
1985 ◽  
Vol 326 (8452) ◽  
pp. 449-450 ◽  
Author(s):  
P.P. Mortimer ◽  
E.M. Vandervelde ◽  
W.J. Jesson ◽  
M.S. Pereira ◽  
F. Burkhardt
Keyword(s):  
Intravenous Drug ◽  
Drug Abusers ◽  
Intravenous Drug Abusers

scholarly journals Alcohol Abuse and Stage of HIV Disease in Intravenous Drug Abusers

1996 ◽  
Vol 89 (7) ◽  
pp. 389-392 ◽  
Author(s):  
Gerond Lake-Bakaar ◽  
Roger Grimson
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Abuse ◽  
Hiv Positive ◽  
Drug Abusers ◽  
Hiv Disease ◽  
Needle Sharing ◽  
Heavy Drinkers ◽  
History Of ◽  
Intravenous Drug Abusers ◽  
Hiv Negative

Our objective was to identify factors that might correlate with human immunodeficiency virus (HIV) disease stage in intravenous drug abusers (IVDA). Particular attention was given to alcohol abuse. We accordingly explored in a cross-sectional study the relation between stage of HIV disease and age, sex, needle sharing, ethnicity, self-reported history of alcohol consumption and CAGE scores. IVDA from a single municipal hospital were subdivided into three groups according to HIV disease status. Group 1 comprised 42 individuals with AIDS; group 2 comprised 114 who were HIV positive but without AIDS; and group 3 comprised 52 who were HIV negative. Information on alcohol consumption and CAGE responses were obtained by questionnaire and interview. Discriminant analysis indicated that alcohol abuse, assessed either by self-reported consumption or by CAGE scores, was significantly more common in the AIDS group than in either the HIV positive or the HIV negative groups, when controlled for age, sex, and needle sharing status. The relative risk of AIDS was 3.8 times higher in the heavy drinkers than in moderate drinkers. Needle sharing was also more common in the AIDS group than in the HIV positive or HIV negative groups when the other factors were controlled for. AIDS was more common in black than white IVDA, and this increased frequency did not appear related to alcohol consumption since the distribution of heavy drinkers within each category of HIV disease did not differ within the ethnic groups. These data indicate that a history of heavy alcohol consumption is more common in IVDA with AIDS than in IVDA at earlier stages of HIV disease.

Surgical Management of Infected Pseudoaneurysms in Intravenous Drug Abusers: Single Institution Experience and a Proposed Algorithm

2009 ◽  
Vol 33 (9) ◽  
pp. 1830-1835 ◽  
Author(s):  
Ker-Kan Tan ◽  
Kenneth Chen ◽  
Kok-Hoong Chia ◽  
Chee-Wei Lee ◽  
Sanjay Nalachandran
Keyword(s):  
Surgical Management ◽  
Intravenous Drug ◽  
Drug Abusers ◽  
Single Institution ◽  
Intravenous Drug Abusers
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