Case Report
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Morel-Lavallée lesion (MLL) is a closed degloving soft tissue injury that occurs when there is abrupt separation of skin and subcutaneous tissue from the underlying fascia. It usually develops following high-velocity trauma and crush injuries. This is a case report of a young female who had a fall and presented with a large swelling in her left thigh and was diagnosed to have a MLL. She underwent drainage of the collection; the wound was left open and allowed to heal by secondary intention.
Review Article
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Burnout has a significant impact on the individual in terms of their physical and psychological well-being. The negative flow-on effects on the organization’s productivity and workforce, in general, are also important to recognize. In the healthcare sector, burnout of clinicians can impact the quality of care and patient safety outcomes. It is important and necessary to understand the contributing systemic, organizational, and individual-specific factors to develop a holistic response to prevent burnout. An integrated approach should be aimed at the systems level, which requires continual monitoring and assessment of resilience and workloads; at the organizational level, identifying factors unique to the organization type and setting; and at the individual level, focused on their well-being.
Review Article
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The impact of burnout is significant on individuals and the organization. It is important to understand the progressive evolution of burnout symptoms to ensure that intervention is appropriate for the burnout stage that the person may be in. A timely intervention appropriate for the stage of burnout has the potential to ensure that necessary support is made available to the individual to stop the further evolution of burnout symptoms. Moreover, understanding the experiences of an individual provides an opportunity to address organizational systems and processes that may be contributing to burnout.
Clinical Case Report
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The consistency of the myxoma is often dense fibrous, or jelly-like mucous. Myxoma consists of undifferentiated mesenchymal cells of various shapes (rounded, stellate), which are located in the myxoid stroma. Myxoma is the most common primary cardiac tumor (up to 50% of all primary cardiac neoplasms). Myxoma of the stomach is a rare pathology. We could not find any information covering the issues of gastric myxoma in children. This article provides a clinical observation of a good result of surgical treatment of gastric myxoma in a 2-year-old child. The described clinical case indicates the need to create a unified register of rare tumors for their study.
Case Report
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Purpose: To describe the case of a uniocular patient with advanced primary open-angle glaucoma (POAG) and age-related cataract in the right eye and microphthalmic left eye.
Methods: A 73-year-old one-eyed man presented with four years of painless, progressive dimness of vision in the right eye. The vision was 6/18 in the right eye, whereas the left eye had no light perception (NLP). In the left eye, severe ptosis and microphthalmos were detected, while the right eye had age-related cataracts, an open anterior chamber angle, intraocular pressure (IOP) of 30 mmHg, and progressive glaucomatous optic neuropathy.
The IOP was dropped to 22 mmHg after a topical timolol maleate (0.5%), brimonidine tartrate (0.2%), and brinzolamide (1%). As the patient had mature cataract, advanced glaucomatous optic nerve damage, target IOP was not reached, and adherence issues with antiglaucoma medications (AGM), the decision was made to proceed with cataract extraction combined with augmented trabeculectomy with mitomycin-C (MMC).
Results: There were no intraoperative complications. Over one year, the IOP was maintained in the 12–14 mmHg range without AGM.
Conclusion: In advanced glaucoma patients, combined phaco-trabeculectomy operations can considerably lower IOP and drug load or compliance concerns with antiglaucoma drugs. This case represented an efficient and safe surgical technique for uniocular advanced POAG, particularly in a developing country like Bangladesh.
Research Article
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Background: Clinical and diagnostic challenges are due to the result of a variable presentation of neonatal sepsis and bloodstream infections (BSIs) and uncertain disease epidemiology in children below five years of age. Although the criteria for achieving an adequate blood culture specimen in adults have been well described, there is much more equivocation in the pediatric population, especially for the under-five-year age group. Therefore, the present study is designed to evaluate the etiological profile of BSI among under-five children by the automated BACTEC systems.
Materials and Methods: All blood culture samples received in the Department of Microbiology for culture falling in the age group were included in the study for a period of one year from 01 July 2015 to 30 June 2016 using the BD BACTEC FX except in the exclusion criteria. The blood culture was observed in the BD BACTEC FX system for at least five days before being reported as sterile.
Results: A total of 1533 samples in the age group of < 5 years and suspected of BSIs were received in the Department of Microbiology, Indira Gandhi Medical College (IGMC), Shimla. Among them, 963 (62.8%) were males, while 570 (37.2%) were females. Among the total of 1533 samples, 604 (39.40%) were found positive in culture, 898 (58.57%) were negative, and 31 (2.02%) were contaminants. Among the 604 positive cases, 390 (64.6%) were men, while 214 (35.4%) were women. S. aureus was the highest among the gram-positive isolates 98 (16.22%), followed by coagulase-negative Staphylococcus, group B Streptococcus, and S. pneumoniae. Among the gram-negative organisms, E. coli 80 (13.24%) was isolated mostly followed by K. pneumoniae 70 (11.58%), P. aeruginosa 68 (11.25%), Salmonella typhi 50 (8.27%), Citrobacter koseri 18 (2.98%), Acinetobacter baumannii 12 (1.98%) and a group of organisms without fermentation 86 (14.23%).
Conclusion: There was quite high positivity in culture in the preschool group. Positivity was significantly high in males as compared to females. It is essential to administer appropriate and synergistic antimicrobial agents empirically early and appropriately for treating children under five-year age with BSI.
