• Title/Summary/Keyword: Hospital Infection Management

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Partial fetotomy: technique to resolve wry neck dystocia in mare

  • Hassan, Mubbashar;Shahid, Sana;Asif, Akhtar Rasool;Naveed, Muhammad Ilyas;Shahzad, Abid Hussain;Khan, Mumtaz Ali
    • Journal of Animal Reproduction and Biotechnology
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    • v.35 no.4
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    • pp.366-369
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    • 2020
  • Foaling is a process of giving birth to foal which is prompt and forceful event in equine breeding. Dystocia is declared when 2nd stage of parturition exceeds from 20 min without fetal movements in mare. Dystocia is very challenging situation for both mare and veterinarian. Survivability of mare and foal, and subsequent fertility of mare depends on efficient management. Therefore, the current report described a rare case of wry neck (torticollis or unilateral bent neck) resulted in dystocia, that was efficiently resolved by partial fetotomy and repulsion technique in mare under field conditions. Intensive post operative care was performed to avoid infection and to achieve fertility subsequently.

Human Bites Over Nose: Management and Reconstruction

  • Kuldeep Singh;Krittika Aggarwal
    • Archives of Plastic Surgery
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    • v.50 no.2
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    • pp.171-176
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    • 2023
  • Background Human bite wounds in emergency department need evaluation in regard of reconstruction. These are due to occlusive bite injuries over face. Most commonly, human bites over face involve ear and nose, and may lead to avulsion injury. Defects over nose can be reconstructed immediately after debridement or delayed till the wound heals and scar becomes supple. Thorough wash and lavage with broadspectrum antibiotic cover has utmost importance in preventing cartilage infection. Methods We report 20 cases of human bite injuries over nose who presented to us in emergency department between 2018 and 2020. At the time of presentation the wound was assessed for closure. If not possible, patient was planned for delayed reconstruction after 3 months. In case delayed reconstruction was planned, the skin and nasal mucosa were approximated at first presentation. The patients underwent paramedian forehead flap after recreation of defect with conchal cartilage graft. Second stage of flap detachment and insetting was done after 3 weeks. After three weeks of second stage, third stage of flap thinning was done. Patients were followed for 3-6 months and subjective satisfaction was noted. Results Nineteen patients underwent delayed staged reconstruction with paramedian forehead flap and one underwent primary wound closure. The flap survival was 100%. The patient satisfaction was excellent in most cases. Conclusion We recommend delayed reconstruction for human bite nasal injuries. For reconstruction, paramedian forehead flap with conchal cartilage graft, if required, provides excellent reconstructive option with good contour and color match and minimal donor site scar.

Successful treatment of dog bite-induced sepsis in a dog receiving long-term immunosuppressant

  • Sooyoung Son;Woo-Jin Song
    • Korean Journal of Veterinary Service
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    • v.47 no.2
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    • pp.89-94
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    • 2024
  • A 5-year-old spayed female mixed-breed dog, previously receiving 7 months of immunosuppressive therapy for pemphigus foliaceus, presented to our referral hospital with a history of dog bites on the right forelimb, chest, and flank 4 days prior to presentation. Physical examination revealed a rectal temperature of 38.6℃; heart rate of 130 beats per minute; panting; systolic blood pressure of 60 mmHg; and swelling, purulent discharge, warmth, pain, and lameness in the right forelimb. The laboratory investigation revealed neutropenia and elevated C-reactive protein levels. Suppurative neutrophilic infiltration with bacterial infection was detected by impression cytology of the pus on the right forelimb. Based on the results of the clinical examinations and laboratory tests, the dog was diagnosed with dog bite-induced sepsis with pemphigus. Meropenem and metronidazole were prescribed. Clinical signs, neutropenia, and C-reactive protein levels markedly improved after 5 days. Subsequently, pemphigus foliaceus relapsed in the dog, and it is currently undergoing re-administration of immunosuppressive medications. To the best of our knowledge, this is the first case report of successful management of dog bite-induced sepsis in a dog undergoing long-term immunosuppressive therapy.

Clinical Presentation and Prognosis of SARS-CoV-2 Infection in Infants Aged ≤90 Days: Insights for Management During Outbreaks

  • Hye Jeong Moon;Mi Seon Han;Kyung Min Kim;Kyung Jin Oh;Ju Young Chang;Seong Yong Lee;Ji Eun Choi
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.84-90
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    • 2023
  • Purpose: Infants aged ≤90 days with fever are susceptible to severe infections. This study aimed to analyze the clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in this particular age group. Methods: Infants aged ≤90 days who were diagnosed with coronavirus disease 2019 (COVID-19) and hospitalized between March 1, 2020, and May 1, 2022 were included. Medical records of patients were retrospectively reviewed. Results: A total of 105 infants with COVID-19 were included; 27 (25.7%) neonates aged <28 days, and 48 (45.7%) and 30 (28.6%) infants aged 28-59 days and 60-90 days, respectively. Five (4.7%) patients remained asymptomatic and 68 (62.8%) were febrile, with a median fever duration of 2 days. The most common symptoms were respiratory including cough (66.6%), nasal stuffiness (51.4%), and rhinorrhea (40.9%). Blood cultures were performed in 10 infants but no organisms were detected. Cultures of bag-collected urine specimens from 8 infants were grown, resulting in positive growth for 2 without pyuria. Nine (8.6%) infants were treated with empirical antibiotics for a median duration of 2.3 days (range, 1-7 days). All 105 infants showed improvement without any complications, and there were no fatal cases. Conclusions: In this study, most infants aged ≤90 days with COVID-19 presented with mild symptoms and none of those evaluated had documented bacterial co-infection. The favorable prognosis among young infants with SARS-CoV-2 may aid clinicians in tailoring their approach to evaluation and management during outbreaks.

Molecular Subtyping of Methicillin-Resistant Staphylococcus aureus Isolated from Patients' Nasal Cavity (환자의 비강으로부터 분리된 메티실린 내성 황색 포도알균의 분자 아형 분석)

  • Kim, Sang-Ha;Park, Sung-Bae;Park, Heechul;Kim, Jun Seong;Kim, Jungho;Lee, Jiyoung;Lim, Jaewon;Kim, Young Kwon;Kim, Sunghyun
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.2
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    • pp.128-135
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    • 2020
  • Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that causes infections in different parts of the body and causes skin and soft tissue infections (SSTI). The present study examined the antimicrobial resistance patterns and molecular epidemiological characteristics of MRSA isolated from nasal swabs in clinical patients. SCCmec type of MRSA isolates from clinical patients were analyzed: 24 cases were SCCmec type-II; two cases were type-II/IVa; one case was type-II/V; one case was type-IVa; 11 cases were not-typeable. The mec complex type of MRSA isolates from clinical patients were analyzed: 29 cases were mec complex type A, and 10 cases were not-typeable, but type B was not found in the present study. In conclusion, SCCmec type-II and mec complex type A were the most dominant MRSA subtypes among the MRSA isolates from a nasal swab of patients, and the results were similar to other studies on hospital-acquired MRSA (HA-MRSA). These results can not only provide basic data for hospital infection management but also be a good guideline for MRSA infections in the Republic of Korea.

Epidemics of Lower Respiratory Tract Infection that Occurred to Children at a Local Institute for Children's Adoption and Welfare (모 입양 기관에 수용 중인 영유아에서의 하기도 감염의 유행)

  • Yang, Mi Hwa;Park, Chan Sook;Yoon, So Young;Kim, Jae Youn;Ahn, Don Hee
    • Pediatric Infection and Vaccine
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    • v.9 no.2
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    • pp.201-207
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    • 2002
  • Purpose : We analyzed clinical features and causal viruses of acute lower respiratory tract infections(LRTIs) in order to improve the management of these infections. Methods : From end of April to early May 2001, amongst 30 children at a local institute for children's adoption and welfare, 13 were admitted to the hospital with the diagnostic impression of acute LRTIs. Nasopharyngeal aspirates were sent in Seoul National University Hospital for viral culture of respiratory syncytial virus(RSV), adenovirus, parainfluenza virus. Results : One or more viral agents were identified in 4 cases(30.7%) : were RSV(15.4%), adenovirus(7.7%), and a mix of these two viruses(7.7%). Initial symptoms were fever(69%), cough(100%), tachypnea(54%), chest retraction(69%), rale(85%) and wheezing(15%). Leukocytosis was noted in 23%, CRP increased more than 10 mg/L in 46%. Chest X-ray abnormalities were 69%. Conclusion : Although viruses were identified in 30.7%, further studies should be made for prevention and treatment of acute viral LRTIs.

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Nursing Activities and Outcomes Related to Indwelling Urinary Catheterization from a Review of Medical Records and Interviews (의무기록지 분석과 간호사 면담을 통한유치도뇨관 관리에 관한 간호활동 및 환자결과)

  • Jang, Keum-Seong;Chung, Kyung-Hee;Choi, Ja-Yun;Yang, Jin-Ju;Park, Soon-Joo;Ryu, Se-An;Kim, Nam-Young;Sim, Jae-Youn
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.4
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    • pp.438-448
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    • 2008
  • Purpose: The purpose of this study was to identify nursing activities and to analyze patient outcomes related to indwelling urinary catheterization. Method: A review was done of 628 medical records from five units for patients admitted between January 1 and June 30, 2006. Twelve nurses who worked in the same units were interviewed. Results: In the interviews, nurses reported considering several non-invasive interventions prior to catheterization but there were no medical records of this activity. Results from the in-depth interviews showed that infection control activities such as urinary bag management were conducted but again there were no medical records. Seventy-five percent of the catheters were removed without prescription. In the medical records there were no notes for approximately 15%, on the time of first voiding and 80%, on volume of first voiding after removal of catheter. There was a significant difference in hospitalization days between the group catheterized for 5 days or less and the group catheterized for 6 days or more. Conclusion: Results indicate a need to close the gap between recorded and described activities and between current and best evidence based practice. Further study is needed to develop a standard recording system and guidelines related indwelling catheterization to decrease the gaps identified in this research.

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A Case of Vivax Malaria Complicated by Adult Respiratory Distress Syndrome and Successful Management with Extracorporeal Membrane Oxygenation

  • Lee, Hyun-Jung;Baek, Ji-Hyeon;Chae, Myoung-Hun;Joo, Hoyeon;Lee, Jin-Soo;Chung, Moon-Hyun;Park, Yun-Kyu;Kim, Joung-Teak
    • Parasites, Hosts and Diseases
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    • v.51 no.5
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    • pp.551-555
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    • 2013
  • Complicated malaria is mainly caused by Plasmodium falciparum, but, increasingly, Plasmodium vivax is also being reported as a cause. Since the reemergence of indigenous vivax malaria in 1993, cases of severe malaria have been steadily reported in Korea. Herein, we report a case of vivax malaria complicated by adult respiratory distress syndrome (ARDS) that was successfully managed with extracorporeal membrane oxygenation (ECMO). A 59-year-old man presented at our hospital with fever and abdominal pain, which had persisted for 10 days. On admission, the patient had impaired consciousness, shock, hypoxia and haziness in both lungs, jaundice, thrombocytopenia and disseminated intravascular coagulation, metabolic acidosis, and acute kidney injury. A peripheral blood smear and a rapid diagnostic test verified P. vivax mono-infection. Ten hours after admission, hypoxia became more severe, despite providing maximal ventilatory support. The administration of antimalarial agents, ECMO, and continuous venovenous hemofiltration resulted in an improvement of his vital signs and laboratory findings. He was discharged from the hospital 7 weeks later, without any sequelae.

Development of Indwelling Urinary Catheterization Guideline by Adaptation Process (수용개작방법을 활용한 유치도뇨 간호실무지침 개발)

  • Jeong, Ihn Sook;Jeong, Jae Sim;Seo, Hyun Ju;Lim, Eun Young;Hong, Eun-Young;Park, Kyung Hee;Jung, Young Sun;Choi, Eun Kyoung;Park, Hee Youn;Park, Sun-A
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.1
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    • pp.31-42
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    • 2015
  • Purpose: This study was done to develop evidence-based nursing practice guidelines to prevent complications related to indwelling urinary catheterization (IUC) in patients in Korea. Methods: A guideline adaptation process was conducted according to the guideline adaptation manual which consists of three main phases, and 9 modules with a total of 24 steps. Results: The newly developed IUC guideline consisted of an introduction, urinary catheterization, summary of recommendations, recommendations, references, and appendices. There were 110 recommendations in 8 sections including assessment, equipment, catheter insertion, catheter maintenance, catheter change, catheter removal, management of complications, and education/consultation. For the grade of recommendations, there were 6.4% for A, 22.7% for B, 67.3% for C. Conclusion: The IUC guideline was developed based on evidence and therefore it is recommended that this guideline be disseminated and utilized by nurses nationwide to improve the quality of care for patients with IUC and decrease complications related to IUC and that it be revised regularly.

Personal Use of Medical Equipment in Home Care Patients (가정간호 대상자의 의료 기구사용에 관한 조사연구)

  • Lim Nan-Young;Kim Keum-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.1
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    • pp.64-77
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    • 1999
  • This study was conducted to investigate the use of medical equipment in patients receiving home care service. The subjects of this study were 88 patients cared by seven home care nursed who were registered in the Seoul Nurses Association. Data was collected from Aug. 1, 1998 to Dec. 30, 1998. The findings are as follows. 1. The sample was found to be 55.7% female : 51.7% over 65 years old. 75% with neurologic disease including CVA, brain tumor, ICH, Parkinsonism & Spinal stenosis and 78.4% living in Seoul. The Clinical experience of the home care nurses was greater than five years. 2. Medical equipment which the patients possessed were foley catheters(61.4%), L-tubes(59.1%) and tracheostomy tubes(51.1%). 3. Technical difficulties in use of medical equipment were related to home care ventilators(60.0%), L-tubes(3.8%) and tracheostomy tubes(2.2%). 4. Most of the medical equipment were obtained from the hospital where they had been admitted previously or from medical equipment companies. 5. Complications from the use of this equipment were infection through invasive techniques including wound drainage tubes(50%), and IV injections(22.2%), The complications were resolved through referral to the doctor of the hospital where they were previously admitted or through community health centers. 6. Most of the equipment was disposable, and equipment was disinfected by using various methods including boiling and soaking in antiseptic solutions. These findings suggest that consistant policy on the management of medical equipment is necessary for the safety of home care patients.

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