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Yuvaraj Krishnamoorthy Komala Ezhumalai Sharan Murali Sathish Rajaa Maria Jose Abilasha Sathishkumar Govindarajan Soundappan Charles Horsburgh Natasha Hochberg William Evan Johnson Selby Knudsen Padmini Salgame Jerrold Ellner Senbagavalli Prakash Babu Sonali Sarkar 《Tropical medicine & international health : TM & IH》2021,26(12):1645-1651
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Aravind Periyasamy Gandhi Soundappan Kathirvel Tanveer Rehman 《Journal of Rural Medicine》2022,17(2):59
Objectives: The coronavirus disease 2019 (COVID-19) pandemic affected routine healthcare services across all spectra, and tuberculosis (TB) care under the National Tuberculosis Elimination Program have been affected the most. However, evidence available at the community level is minimal. The clinical features, care cascade pathway, and treatment outcomes of TB patients pre- and during/post-COVID-19 pandemic lockdown in a rural community health block in northern India were assessed and compared.Materials and Methods: This was a retrospective cohort study that included all patients diagnosed with TB and initiated treatment under programmatic settings between January 1 and June 30, 2020, in a rural TB unit in northern India. The periods from January 1 to March 23 and March 24 to June 30 were marked as pre-lockdown and during/post-lockdown, respectively.Results: A total of 103 patients were diagnosed and treated for TB during the study period. A significantly higher proportion of pulmonary TB cases were reported during/post-lockdown (43, 82.7%) compared to that pre-lockdown (32, 62.7%), and a higher diagnostic delay was noted during/post-lockdown (35, 81.4%). Through adjusted analysis, patients diagnosed during/post-lockdown period (adjusted risk ratio [aRR], 0.85; 95% confidence interval [CI], 0.73–0.98) and previously treated (aRR, 0.77; 95% CI, 0.60–0.995) had significantly lower favorable treatment outcomes.Conclusions: The symptom and disease (pulmonary/extrapulmonary) pattern have changed during/post-lockdown. The care cascade delays are still high among TB patients, irrespective of the lockdown status. Lockdown had a significant adverse impact on the outcomes of TB treatment. 相似文献
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Pneumothorax after blunt chest trauma in the absence of rib fractures is uncommon and has only rarely been reported as a result of sporting activity. Presentation may vary from an apparently normal physical examination in the presence of a small pneumothorax to hemodynamic compromise in the presence of a tension pneumothorax. High fitness levels in athletes may result in failure to recognize symptoms and delay diagnosis, potentially increasing morbidity. It is imperative for the emergency physician to exclude pneumothorax in children who present with chest pain after blunt chest trauma from sports injury. We report our experience with and the management of 3 patients with pneumothoraces. 相似文献
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Marchant J Cheng NG Lam LT Fahy FE Soundappan SV Sounndapound SV Cass DT Browne GJ 《The Medical journal of Australia》2008,188(8):484-485
Eight children suffered drowning or near-drowning in Sydney pools over an 11-day period in January 2007. Four received basic life support (BLS) within 5 minutes of immersion and survived with good functional neurological outcomes. The other four were not discovered for >or= 5 minutes and all died. This cluster serves as a reminder that timely effective bystander BLS is crucial to survival and good clinical outcomes in near-drowning episodes. 相似文献
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Rachel D'Cruz Soundappan SV Soundappan Daniel T Cass Grahame Smith 《Journal of paediatrics and child health》2009,45(10):564-566
Aim: To review urethral injuries arising from incorrect balloon inflation in children undergoing urinary catheterisation.
Method: Retrospective review from 1995–2006. Children who sustained catheter-related injury at The Children's Hospital at Westmead were identified through medical records database and reviewed.
Results: Six patients were identified over the 11-year period. All six were boys. Age ranged from <1 month to 16 years. All but one occurred in hospital. All injuries were confirmed by urethrogram. Bulbar and prostatic urethra was involved in an equal number of children studied. Three patients required suprapubic catheters. Follow-up imaging revealed healing without stricture in all patients.
Conclusion: Balloon-related urethral trauma can be avoided by educating health-care professionals on proper placement and confirmation of position of catheter. Though there were no long-term complications noted, a temporary suprapubic diversion may be needed. 相似文献
Method: Retrospective review from 1995–2006. Children who sustained catheter-related injury at The Children's Hospital at Westmead were identified through medical records database and reviewed.
Results: Six patients were identified over the 11-year period. All six were boys. Age ranged from <1 month to 16 years. All but one occurred in hospital. All injuries were confirmed by urethrogram. Bulbar and prostatic urethra was involved in an equal number of children studied. Three patients required suprapubic catheters. Follow-up imaging revealed healing without stricture in all patients.
Conclusion: Balloon-related urethral trauma can be avoided by educating health-care professionals on proper placement and confirmation of position of catheter. Though there were no long-term complications noted, a temporary suprapubic diversion may be needed. 相似文献
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Objective: Healthcare services using mobile-phone based telemedicine provide simple technology that does not require sophisticated equipment. This study assessed community health workers’ knowledge, attitude, and practice (i.e., their readiness) at the village level for uptake of mobile-phone based telemedicine.Materials and Methods: This cross-sectional study was conducted among 80 community health workers, including Auxiliary Nurse Midwives, Multipurpose Health Workers and Accredited Social Health Activists working in a rural health block of India. A pre-tested, semi-structured, interviewer-assisted, self-administered questionnaire was used to assess their mobile-phone based telemedicine readiness.Results: Sixty (75.0%) health workers owned mobile phones. The median readiness score for mobile-phone based telemedicine was 109.0. The Accredited Social Health Activists showed a better attitude toward mobile-phone based telemedicine than others. There was a significant moderate positive correlation (r=0.67) between knowledge and practice domains. Community health workers who had smartphones showed a significantly better attitude than those who did not.Conclusion: Training programs on telemedicine service delivery, focused on Auxiliary Nurse Midwives/ Multipurpose Health Workers, can improve their attitudes towards telemedicine. A better attitude of the Accredited Social Health Activists must be leveraged to initiate mobile-phone based telemedicine services on a pilot basis initially and later scaled up in other settings. 相似文献
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A sinus tract presenting with an opening around the angle of mandible is suggestive of first cleft remnant. We present the case of a 4-year-old boy with a recurrent discharging sinus around the angle of the right mandible whose internal opening was near the tonsil on imaging. Complete excision was performed with facial nerve monitoring. We discuss technical aspects of the surgery and possible embryology. 相似文献
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Priapism is a sustained erection that is maintained for over 4 hours in the absence of sexual stimulation [Postgrad Med J. 2006;82(964):89-94; J Urol. 2003;170:1318-1324]. Distinction is made between low- and high-flow variants [J Urol. 2003;170:1318-1324; Cardiovasc Intervent Radiol. 2002;25(4):326-329]. Low-flow priapism (LFP) and acute appendicitis are rarely associated. Including ours, there are 4 cases reported in the literature, all of which have occurred in children. The complications of LFP are potentially serious and include loss of the phallus altogether. Treatment of LFP is should be prompt and is the same irrespective of the etiology. 相似文献
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