Asia ; epidemiology ; Diabetes Mellitus ; epidemiology ; etiology ; prevention & control ; Humans ; Morbidity ; Risk Factors ; Socioeconomic Factors ; Survival Rate

Twenty two patients presenting with chronic non-healing wound of the foot were evaluated. The ages range from 49 to 72 years old. There were 15 males and 7 females. Sixteen patients had NIDDM. Two were diagnosed to have Buergers disease with four others had both NIDDM and Buergers disease. Using a pulse oximeter with a sensor attached to the toes, the oxygen saturation level of the distal limbs was determined. Twelve patients were amputated. The mean oxygen saturation level of the non-amputated group was 91.2%, while that of the amputated group was 32.8%. In the non-amputated group, all the wounds improved. It is therefore suggested that determination of oxygen saturation level using pulse oximeter is a safe and convenient way of predicting wound healing. A level below 80% is correlated with poor healing which may assist the surgeon in his decision to amputate. (Author)

Human ; Male ; Female ; Aged ; Middle Aged ; Oxygen ; Amputation

Acute laryngeal trauma is a great challenge for the otoloaryngologist. Early recognition, accurate evaluation and proper treatment may be crucial to immediate survival and long-term function. Objective:To describe an endoscopically-guided open reduction and adaptation plate fixation of an acute laryngeal fracture secondary to vehicular accident. Methods: a. Study Design: Surgical Innovation/ Case Report b. Setting:Tertiary Hospital in Metro Manila Results: Post-operative follow-up showed good vocal fold function and arytenoid position, with no food regurgitation, signs of aspiration or penetration on fiberoptic endoscopic evaluation of swallowing Conclusion: Endoscopic guidance allows higher magnification minimizing iatrogenic mucosal damage during manipulation. (Author)
LARYNX

The use of local regional flaps is often the most practical and easy means of reconstruction in the management of head and neck tumors. The temporalis muscle coronoid swing has been used to reconstruct the orbital floor and is described in literature as early as 1983. Difficulty is encountered when the medial wall and orbital floor are completely removed and a temporalis muscle-coronoid swing is rendered insufficient for orbital reconstruction. Objective: To describe a combination of forehead island flap and temporalis muscle-coronoid swing in orbital reconstruction. Design: Surgical Innovation/ Case Report. Subject: 12-year-old female with recurrent maxillary chondroblastic osteosarcoma one year after chemotherapy. Methods: The course of tumor excision and defect reconstruction is described. Results:There was no diplopia or other morbidity.There was minimal added operative time for reconstruction with acceptable results. Conclusion: Local flaps can be combined in order to repair the orbital floor. Acceptable function with minimal cosmetic deformity can be achieved with less extensive surgery. (Author)
FOREHEAD TEMPORAL MUSCLE ORBIT RECONSTRUCTIVE SURGICAL PROCEDURES SURGICAL FLAPS

Advances in the medical management of secondary hyperparathyroidism due to renal failure have decreased the use of parathyroidectomy as a treatment option. However, some patients with end-stage renal disease still progress to refractory hyperparathyroidism and debilitating bone disease, for which parathyroidectomy may be warranted. We describe a case of a 35-year-old female on chronic hemodialysis who presented with bone pains, deformities, decrease in height and recurrent pathologic fractures. She had markedly elevated parathyroid hormone (PTH), vitamin D deficiency, persistent hyperphosphatemia and hypocalcemia despite therapeutic measures. Subtotal parathyroidectomy was done with eventual improvement of biochemical abnormalities, resolution of bone pains and healing of fractures.

Human ; Female ; Adult ; Bone Diseases ; Fractures, Spontaneous ; Hyperparathyroidism, Secondary ; Hyperphosphatemia ; Hypocalcemia ; Kidney Failure, Chronic ; Parathyroid Hormone ; Parathyroidectomy ; Renal Dialysis ; Renal Insufficiency ; Vitamin D Deficiency

A total of 97 children aged 1 month to 16 years (mean 6.6 years) had upper endoscopies performed in Paediatric Institute, Kuala Lumpur Hospital between January 1997 and December 1999 for various gastrointestinal symptoms. Of these 70 children were tested for Helicobacter pylori. The four most common indications for upper endoscopy were recurrent abdominal pain, upper gastrointestinal bleeding, epigastric pain and vomiting. The overall prevalence of this infection in this heterogenous group of symptomatic children was 10% (7/70). This study shows that H.pylori positivity in a routine endoscopy population is low and does not appear to be associated with specific symptoms.
Child ; seconds ; Endoscopy ; Prevalence aspects ; Helicobacter pylori

Scrotal calcinosis is a rare condition with controversy surrounding its unclear etiopathogenesis. Several schools of thought have emerged from recent publications supported by histological findings seen in the respective cases reported. The recommendation of surgery as management, and its outcome, however, have remained the same throughout history. This paper reports a 36-year-old male who presented with gradually progressing multiple pruritic nodules over the scrotum who underwent wide excision with favorable outcome on follow up. Histological examination confirmed the diagnosis of scrotal calcinosis and showed evidence of intact epidermoid cysts that have undergone dystrophic calcification.

Adolescent ; Adult ; Ankle Injuries ; Ankle Joint ; diagnostic imaging ; Female ; Humans ; Ligaments, Articular ; diagnostic imaging ; injuries ; Male ; Middle Aged ; Radiography ; Rupture

Assessing the vitamin A status among pre-school-age children is essential for evaluating the magnitude and public health status of vitamin A deficiency in a population. This cross-sectional study assessed the vitamin A status of children aged 6 to 59 months resident in the National Capital District (NCD), Papua New Guinea. Children attending the Children's Outpatient Clinic at Port Moresby General Hospital participated in this study. Informed consent was obtained from parents before using blood samples from their children. Assay of plasma retinol was carried out using the 'Clin-Rep' complete kit for assay of vitamins A and E in plasma by high performance liquid chromatography (HPLC). A commercial enzyme immunoassay kit was used to assay C-reactive protein (CRP) in plasma. Of the 132 children in the study 108 (82%) had received vitamin A capsules. The median plasma retinol concentration of the 132 children was 0.98 micromol/l and the interquartile range 0.65-1.38 micromol/l. Of the 132 children, 35 (27%) had a plasma retinol concentration below 0.70 micromol/l. 75 children (57%) had normal plasma CRP levels and in 57 (43%) the CRP levels were elevated. The median plasma retinol concentration of the children with normal plasma CRP was 1.19 micromol/l and the interquartile range 0.93-1.50 micromol/l. The prevalence of vitamin A deficiency (VAD) in the children with normal plasma CRP was 11%, indicating a moderate public health problem. 74 (56%) males and 58 (44%) females were included in the study. The prevalence of VAD in the male and female children with normal plasma CRP was 14% and 8%, respectively, indicating a moderate public health problem among the male children and a mild public health problem among the female children. The prevalence of subclinical (mild to moderate) and marginal VAD among the children with and without elevated CRP strongly suggests the need for continuous monitoring of the vitamin A status of the vulnerable groups in NCD.
C-Reactive Protein/analysis ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Male ; Papua New Guinea/epidemiology ; Prevalence ; Vitamin A/*blood ; Vitamin A Deficiency/*epidemiology

Insufficient intake of iodine or consumption of foods containing goitrogens can decrease thyroid function leading to multiple physical and mental disorders known collectively as iodine deficiency disorders. Successful implementation of the universal salt iodization strategy, which is the main intervention strategy for the control and elimination of iodine deficiency, requires constant monitoring. Urinary iodine concentration is the recommended biochemical indicator for assessing the iodine status of a population. The present studies were prompted by the apparent lack of published data on the status of iodine nutrition among school-age children in Morobe and Eastern Highlands provinces in Papua New Guinea (PNG). The aims of these studies were to determine the urinary iodine concentration in school-age children (6 – 12 years) as a way of assessing the impact of the salt iodization programs in Morobe and Eastern Highlands Provinces in PNG. These prospective school based cross-sectional studies were carried out in Aseki-Menyamya district Morobe province and Gouno, Mt. Michael Local-Level Government area in Lufa district Eastern Highlands province, PNG. Simple random sampling was used to select primary schools in each district. The iodine content in salt samples was measured using the single wavelength semi-automated WYD Iodine Checker Photometer. Urinary iodine concentration (UIC) was estimated using the Sandell-Kolthoff reaction. In Lufa district, the mean per capita discretionary consumption of salt was 4.7 ± 2.1g per day with a range of 2.1 – 9.6g; the mean iodine content in salt samples from the households was 17.8 ± 4.5ppm; the iodine content was below 15ppm in 23.8% of all the salt samples. For the children in Aseki-Menyamya district, the median UIC was 149.5μg/L, Interquartile Range (IQR) was 70.0 – 300μg/L; the UIC was below 100.0μg/L in 32.9% of the children and 17.9% had UIC below 50μg/L. For children in Gouno Lufa district, the median UIC was 50.0μg/L, IQR was 23.9 – 76.0μg/L, 87.9% had UIC below 100.0μg/L, and 49.2% had UIC below 50.0μg/L. The results indicate that iodine deficiency should be considered a significant public health problem among the school-age children in Gouno Lufa district. Our findings indicate the urgent need for efficient, sustainable, systematic and functional monitoring system to strengthen and improve on the implementation of the USI strategy in both districts.