Maternal death from hemorrhage in low resource settings is frequently due to long delays in transportation to referral centers and/or in obtaining blood and surgical interventions. This case series was designed to dem...Maternal death from hemorrhage in low resource settings is frequently due to long delays in transportation to referral centers and/or in obtaining blood and surgical interventions. This case series was designed to demonstrate the feasibility, efficacy and safety of the non inflatable anti shock garment (NI ASG) for resuscitation and hemostasis in the initial management of obstetric hemorrhage and shock. Fourteen cases of obstetric hemorrhage and hypovolemic shock at Memorial Christian Hospital, Sialkot, Pakistan were managed with a specific clinical protocol based on using NI ASG as the primary intervention. The NI ASG was used to resuscitate and stabilize women with hypovolemic shock from 18 to 57 h. Thirteen patients survived without evidence of morbidity, but one had prolonged shock followed by multiple organ failure and death. This study confirmed that the NI ASG quickly restored the vital signs of most women in severe hemorrhagic shock and stabilized them while awaiting blood transfusion.展开更多
Purpose: Each year, about 270 children are treated at our hospital for appendicitis, and there are 200 ventriculo-peritoneal(VP) shunt procedures. The incidence of primary peritonitis after a VP shunt is 8%to 12%. The...Purpose: Each year, about 270 children are treated at our hospital for appendicitis, and there are 200 ventriculo-peritoneal(VP) shunt procedures. The incidence of primary peritonitis after a VP shunt is 8%to 12%. The purpose of this article is to try and differentiate these 2 entities. Methods: From 1973 to 2003 inclusive, appendicitis was diagnosed in 8 children with a VP shunt at our hospital; there were 7 boys and 1 girl with 5 acute appendicitis and 3 ruptured appendices. The first case was diagnosed on purely clinical grounds, whereas the last 7 were confirmed by ultrasonography and/or computed tomography.Results: All 8 had appendectomy and the shunt was exteriorized in the 3 children with a ruptured appendix. There were no postoperative problems, and the 8 children remained well. Conclusion: Acute appendicitis can and does rarely occur in children with VP shunts; however, in such situations, the correct diagnosis can be confirmed by imaging. The shunt must be temporarily exteriorized if the appendix is ruptured.展开更多
文摘Maternal death from hemorrhage in low resource settings is frequently due to long delays in transportation to referral centers and/or in obtaining blood and surgical interventions. This case series was designed to demonstrate the feasibility, efficacy and safety of the non inflatable anti shock garment (NI ASG) for resuscitation and hemostasis in the initial management of obstetric hemorrhage and shock. Fourteen cases of obstetric hemorrhage and hypovolemic shock at Memorial Christian Hospital, Sialkot, Pakistan were managed with a specific clinical protocol based on using NI ASG as the primary intervention. The NI ASG was used to resuscitate and stabilize women with hypovolemic shock from 18 to 57 h. Thirteen patients survived without evidence of morbidity, but one had prolonged shock followed by multiple organ failure and death. This study confirmed that the NI ASG quickly restored the vital signs of most women in severe hemorrhagic shock and stabilized them while awaiting blood transfusion.
文摘Purpose: Each year, about 270 children are treated at our hospital for appendicitis, and there are 200 ventriculo-peritoneal(VP) shunt procedures. The incidence of primary peritonitis after a VP shunt is 8%to 12%. The purpose of this article is to try and differentiate these 2 entities. Methods: From 1973 to 2003 inclusive, appendicitis was diagnosed in 8 children with a VP shunt at our hospital; there were 7 boys and 1 girl with 5 acute appendicitis and 3 ruptured appendices. The first case was diagnosed on purely clinical grounds, whereas the last 7 were confirmed by ultrasonography and/or computed tomography.Results: All 8 had appendectomy and the shunt was exteriorized in the 3 children with a ruptured appendix. There were no postoperative problems, and the 8 children remained well. Conclusion: Acute appendicitis can and does rarely occur in children with VP shunts; however, in such situations, the correct diagnosis can be confirmed by imaging. The shunt must be temporarily exteriorized if the appendix is ruptured.
