Tropical doctor
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This prospective study spanning three months was undertaken to provide insight to trauma care including intervention times in this centre. Improved organization of trauma care is needed urgently for improved outcomes.
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Skeletal system involvement is a relatively common complication of human brucellosis. However, muscular involvement and psoas abscess are less frequently seen. ⋯ The man was successfully treated with the triple antibiotic regimen with percutaneous drainage of abscess. The woman was treated using an antibiotic combination.
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Patients with moderate to severe osteoarthritis of the knee underwent primary elective knee arthroplasty in a well-equipped hospital in Accra, Ghana. Our main outcome measures was the new modified Oxford Knee scores (preoperative and postoperative scores). Median preoperative and postoperative knee scores were 10 and 42.5, respectively, at last follow-up with a P value<0.05 showing the reliability and significance of the scores. ⋯ Of the seven patients who had surgery, one patient developed a chest infection postoperatively and another had failure of bone graft and required a revision. There was no postoperative wound infection or joint instability. The clinical outcome for this series of patients among other factors has been good within the prevailing circumstances and this shows that knee arthroplasty in developing Africa is a reality in the horizon.
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We describe a young male who presented to the emergency room with sudden onset dyspnea, and was found to have aortic root aneurysm with aortic regurgitation and cardiac tamponade. He underwent a Bentall procedure, and excised aortic root tissue showed epithelioid cell granulomas with panaortitis. ⋯ Although tubercular aortitis is fairly common, tuberculous mycotic aneurysm of the aorta is rare, with involvement of the aortic root being exceedingly uncommon. We report only the fifth case in English literature of tuberculous mycotic aneurysm of the aortic root.
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Human brucellosis is caused by one of the three species of Brucella: Brucella mellitensis, B. abortus, and B. suis. Worldwide, the incidence of human brucellosis ranges from <0.01 to >200 per 100,000 population. Cardiovascular complications occur in <2%, but accounts for most of the mortality. ⋯ A combination of antibiotics and valve replacement is the most acceptable treatment. So far only 15 adult cases have been reported as having been cured with medical therapy alone. We report another case treated successfully with antibiotics alone.